Provider Demographics
NPI:1982764577
Name:MANNINO, JULIETTE ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:JULIETTE
Middle Name:ANN
Last Name:MANNINO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JULIETTE
Other - Middle Name:A
Other - Last Name:MANNINO DROST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:10120 MITCHELL RD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16438-9768
Mailing Address - Country:US
Mailing Address - Phone:814-460-5019
Mailing Address - Fax:
Practice Address - Street 1:145 W 23RD ST
Practice Address - Street 2:SUITE 202
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2858
Practice Address - Country:US
Practice Address - Phone:814-452-7990
Practice Address - Fax:814-456-1528
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP006251G363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner