Provider Demographics
NPI:1780947697
Name:MCMANUS, PATRICIA (PHD, RN)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:PHD, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 W VLIET ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53208-2461
Mailing Address - Country:US
Mailing Address - Phone:414-933-0064
Mailing Address - Fax:414-933-0084
Practice Address - Street 1:3020 W VLIET ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208-2461
Practice Address - Country:US
Practice Address - Phone:414-933-0064
Practice Address - Fax:414-933-0084
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI54631-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse