Provider Demographics
NPI:1699503367
Name:MANLEY, GERI LYNN (APRN, PMH-BC, CHC)
Entity type:Individual
Prefix:
First Name:GERI
Middle Name:LYNN
Last Name:MANLEY
Suffix:
Gender:F
Credentials:APRN, PMH-BC, CHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4605 ONION CREEK CT # A
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:FL
Mailing Address - Zip Code:32033-2066
Mailing Address - Country:US
Mailing Address - Phone:386-748-8129
Mailing Address - Fax:
Practice Address - Street 1:1317 ROUTE 73 STE 200
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-2202
Practice Address - Country:US
Practice Address - Phone:856-439-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9372465163WA0400X
FLAPRN11034150363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)