Manning, Nicole Kelley

Manning, Nicole Kelley is an individual health care provider with primary practice located at 102 Shore Dr Suite 403, Worcester MA 01605-3154. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Manning, Nicole Kelley can be contacted via phone (508) 856-0458.

Contact Information

Primary practice address
102 Shore Dr Suite 403 Worcester MA 01605-3154
Phone: (508) 856-0458
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 236464 Massachusetts

Profile Details

NPI number 1457696015
LBN Legal business name Manning, Nicole Kelley
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2012
Last updated Nov 12th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457696015 NPPES
Massachusetts MEDICAID 110096015A

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