Provider Demographics
NPI:1932885753
Name:ROYBAL, SIERRA MANESS (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:MANESS
Last Name:ROYBAL
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:SIERRA
Other - Middle Name:ASHLEY
Other - Last Name:MANESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:36 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:NC
Mailing Address - Zip Code:28630-1616
Mailing Address - Country:US
Mailing Address - Phone:910-705-0063
Mailing Address - Fax:
Practice Address - Street 1:107 MICA AVE # A
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-8135
Practice Address - Country:US
Practice Address - Phone:828-544-5101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5018339363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health