Provider Demographics
NPI:1063512796
Name:MANACCI, CHRISTOPHER F (DNP, ACNP-C)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:F
Last Name:MANACCI
Suffix:
Gender:M
Credentials:DNP, ACNP-C
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:17819 AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-6130
Mailing Address - Country:US
Mailing Address - Phone:844-764-4633
Mailing Address - Fax:310-861-0855
Practice Address - Street 1:17819 AUBURN RD
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-6130
Practice Address - Country:US
Practice Address - Phone:844-764-4633
Practice Address - Fax:310-861-0855
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHRN191505363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2637758Medicaid
OH2637758Medicaid