Provider Demographics
NPI:1023300977
Name:MANNERING, IRENE HELEN (MD)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:HELEN
Last Name:MANNERING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:IRENE
Other - Middle Name:HELEN
Other - Last Name:KRAMARCZUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:640 W MOANA LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-4903
Mailing Address - Country:US
Mailing Address - Phone:753-240-6997
Mailing Address - Fax:775-323-6814
Practice Address - Street 1:4814 SPARKS BLVD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436
Practice Address - Country:US
Practice Address - Phone:753-240-6997
Practice Address - Fax:775-323-6814
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA124024207N00000X
NV17469207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology