Provider Demographics
NPI:1932847795
Name:MANNING, SALLY ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:SALLY
Middle Name:ELIZABETH
Last Name:MANNING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 HUBBLE RD.
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40484-8278
Mailing Address - Country:US
Mailing Address - Phone:606-365-2780
Mailing Address - Fax:
Practice Address - Street 1:1325 HUBBLE RD.
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:KY
Practice Address - Zip Code:40484-8278
Practice Address - Country:US
Practice Address - Phone:606-365-2780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider