Provider Demographics
NPI:1679854244
Name:MANUEL, MICHELLYN A (RCP)
Entity Type:Individual
Prefix:
First Name:MICHELLYN
Middle Name:A
Last Name:MANUEL
Suffix:
Gender:F
Credentials:RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 W HORIZON RIDGE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-3494
Mailing Address - Country:US
Mailing Address - Phone:702-914-2790
Mailing Address - Fax:702-914-5984
Practice Address - Street 1:1655 W HORIZON RIDGE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-3494
Practice Address - Country:US
Practice Address - Phone:702-914-2790
Practice Address - Fax:702-914-5984
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRC1995227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified