Provider Demographics
NPI:1801238241
Name:MANALANG, AGNES MACALINAO (NP-C)
Entity type:Individual
Prefix:MRS
First Name:AGNES
Middle Name:MACALINAO
Last Name:MANALANG
Suffix:
Gender:F
Credentials:NP-C
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Mailing Address - Street 1:8936 SPANISH RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1354
Mailing Address - Country:US
Mailing Address - Phone:702-998-2816
Mailing Address - Fax:702-998-2991
Practice Address - Street 1:3940 N. MARTIN LUTHER KING BLVD
Practice Address - Street 2:STE 105B
Practice Address - City:NORTH HILLS
Practice Address - State:NV
Practice Address - Zip Code:89032
Practice Address - Country:US
Practice Address - Phone:702-731-0909
Practice Address - Fax:027-241-9787
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2019-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CANP 22752363LF0000X
NVAPRN001534363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1801238241Medicaid