Provider Demographics
NPI:1740078872
Name:MANNING, TYSHA
Entity type:Individual
Prefix:
First Name:TYSHA
Middle Name:
Last Name:MANNING
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8506 W 85TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-2764
Mailing Address - Country:US
Mailing Address - Phone:913-523-3553
Mailing Address - Fax:
Practice Address - Street 1:9910 N 48TH ST STE 108B
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68152-1548
Practice Address - Country:US
Practice Address - Phone:402-799-1799
Practice Address - Fax:402-819-0949
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant