Provider Demographics
NPI:1912774407
Name:MANIO, PATRICIA ARIELLE CORPUZ (PA-C)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA ARIELLE
Middle Name:CORPUZ
Last Name:MANIO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 SAFRAN CT UNIT A
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-2449
Mailing Address - Country:US
Mailing Address - Phone:765-506-7516
Mailing Address - Fax:
Practice Address - Street 1:1000 BLYTHE BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5812
Practice Address - Country:US
Practice Address - Phone:704-446-5185
Practice Address - Fax:704-446-0221
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical