Provider Demographics
NPI:1740616697
Name:MANLEY, COLLEEN A (RN)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:A
Last Name:MANLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1082 OLD CHURCHMANS RD
Mailing Address - Street 2:STE 100
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2143
Mailing Address - Country:US
Mailing Address - Phone:302-444-8156
Mailing Address - Fax:302-731-8158
Practice Address - Street 1:1082 OLD CHURCHMANS RD
Practice Address - Street 2:STE 100
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2143
Practice Address - Country:US
Practice Address - Phone:302-444-8156
Practice Address - Fax:302-731-8158
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered