Provider Demographics
NPI:1992007769
Name:MANNING, STACEY ANNETTE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:STACEY
Middle Name:ANNETTE
Last Name:MANNING
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6662 ORLEANS CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-1251
Mailing Address - Country:US
Mailing Address - Phone:513-432-6622
Mailing Address - Fax:
Practice Address - Street 1:6662 ORLEANS CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-1251
Practice Address - Country:US
Practice Address - Phone:513-432-6622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN117300164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse