Provider Demographics
NPI:1881844538
Name:MENNINGER, MICHAEL CHARLES (RN-BC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:CHARLES
Last Name:MENNINGER
Suffix:
Gender:M
Credentials:RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 NAVAL NUCLEAR POWER TRAINING COMMAND CIR
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445
Mailing Address - Country:US
Mailing Address - Phone:858-794-6835
Mailing Address - Fax:
Practice Address - Street 1:110 NAVAL NUCLEAR POWER TRAINING COMMAND CIR
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445
Practice Address - Country:US
Practice Address - Phone:858-794-6835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001254793163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management