Provider Demographics
NPI:1427366558
Name:MCMANUS MILLER, NANCY (NCMT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MCMANUS MILLER
Suffix:
Gender:F
Credentials:NCMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 AVENIDA DE LA PAZ
Mailing Address - Street 2:
Mailing Address - City:LAMY
Mailing Address - State:NM
Mailing Address - Zip Code:87540-9523
Mailing Address - Country:US
Mailing Address - Phone:505-466-1643
Mailing Address - Fax:
Practice Address - Street 1:105 AVENIDA DE LA PAZ
Practice Address - Street 2:
Practice Address - City:LAMY
Practice Address - State:NM
Practice Address - Zip Code:87540-9523
Practice Address - Country:US
Practice Address - Phone:505-466-1643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3625225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist