Provider Demographics
NPI:1912774407
Name:MANIO, PATRICIA ARIELLE CORPUZ (PA)
Entity type:Individual
Prefix:
First Name:PATRICIA ARIELLE
Middle Name:CORPUZ
Last Name:MANIO
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Gender:
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-253-1731
Mailing Address - Fax:
Practice Address - Street 1:2400 UNSER BLVD SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-3392
Practice Address - Country:US
Practice Address - Phone:505-559-6100
Practice Address - Fax:505-253-1201
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2025-05-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMPA2024-0127363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant