Provider Demographics
NPI:1699227892
Name:MANHART, ASHLEY M (MSN, CDE)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:MANHART
Suffix:
Gender:F
Credentials:MSN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 MERCY DR
Mailing Address - Street 2:ATTN: DIABETIC EDUCATION
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-3128
Mailing Address - Country:US
Mailing Address - Phone:402-717-3422
Mailing Address - Fax:402-717-8916
Practice Address - Street 1:800 MERCY DR
Practice Address - Street 2:ATTN: DIABETIC EDUCATION
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-3128
Practice Address - Country:US
Practice Address - Phone:402-717-3422
Practice Address - Fax:402-717-8916
Is Sole Proprietor?:No
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA134722163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator