Manning, Theresa

Manning, Theresa is an individual health care provider with primary practice located at 120 Beacon St Ste 202 House Call Program, Somerville MA 02143-4398. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Manning, Theresa can be contacted via phone (617) 868-6323.

Contact Information

Primary practice address
120 Beacon St Ste 202 House Call Program Somerville MA 02143-4398
Phone: (617) 868-6323
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 192595 Massachusetts

Profile Details

NPI number 1417079922
LBN Legal business name Manning, Theresa
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2007
Last updated Feb 7th, 2012 - 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 1417079922 NPPES
Massachusetts MEDICAID 110074832A
Massachusetts Other NP1088

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