Provider Demographics
NPI:1750104352
Name:MANRY, DANIELLE NICHOLE (FNP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:NICHOLE
Last Name:MANRY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5995 HARRIS TAP LN
Mailing Address - Street 2:
Mailing Address - City:NORTH ZULCH
Mailing Address - State:TX
Mailing Address - Zip Code:77872-2311
Mailing Address - Country:US
Mailing Address - Phone:832-372-9236
Mailing Address - Fax:
Practice Address - Street 1:5995 HARRIS TAP LN
Practice Address - Street 2:
Practice Address - City:NORTH ZULCH
Practice Address - State:TX
Practice Address - Zip Code:77872-2311
Practice Address - Country:US
Practice Address - Phone:832-372-9236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1133208163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse