Provider Demographics
NPI:1932310430
Name:MANZ, NANCY KATHLEEN (RN)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:KATHLEEN
Last Name:MANZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10218 DOUGLAS OAKS CIRCLE
Mailing Address - Street 2:#203
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610
Mailing Address - Country:US
Mailing Address - Phone:813-318-6164
Mailing Address - Fax:813-318-6496
Practice Address - Street 1:10218 DOUGLAS OAKS CIRCLE
Practice Address - Street 2:#203
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610
Practice Address - Country:US
Practice Address - Phone:813-318-6164
Practice Address - Fax:813-318-6496
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN9219117OtherRN LICENSE