Provider Demographics
NPI:1891509808
Name:MANNINO, DAWN ROBIN
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:ROBIN
Last Name:MANNINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 BATES BLVD
Mailing Address - Street 2:
Mailing Address - City:LODGEPOLE
Mailing Address - State:NE
Mailing Address - Zip Code:69149-5043
Mailing Address - Country:US
Mailing Address - Phone:720-275-6432
Mailing Address - Fax:
Practice Address - Street 1:341 BATES BLVD
Practice Address - Street 2:
Practice Address - City:LODGEPOLE
Practice Address - State:NE
Practice Address - Zip Code:69149-5043
Practice Address - Country:US
Practice Address - Phone:720-275-6432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide