Provider Demographics
NPI:1487809208
Name:MANLEY, MARIANNE CATHERINE (RN, CNM)
Entity type:Individual
Prefix:MRS
First Name:MARIANNE
Middle Name:CATHERINE
Last Name:MANLEY
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3876 CODY STREET
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-4617
Mailing Address - Country:US
Mailing Address - Phone:858-273-2049
Mailing Address - Fax:
Practice Address - Street 1:3876 CODY STREET
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-4617
Practice Address - Country:US
Practice Address - Phone:858-273-2049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC361373163W00000X
CANMW753176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse