Provider Demographics
NPI:1013236652
Name:MANUEL, ELSIE (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ELSIE
Middle Name:
Last Name:MANUEL
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 N HWY 360 STE 100
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-6402
Mailing Address - Country:US
Mailing Address - Phone:972-606-8300
Mailing Address - Fax:972-606-8597
Practice Address - Street 1:2740 N HWY 360
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-6403
Practice Address - Country:US
Practice Address - Phone:972-606-8300
Practice Address - Fax:972-606-8597
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX532209363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily