Provider Demographics
NPI:1992123582
Name:MANKE, DAVID F (CRNA)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:F
Last Name:MANKE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 OSAGE ST
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:NE
Mailing Address - Zip Code:69162-1714
Mailing Address - Country:US
Mailing Address - Phone:308-254-5825
Mailing Address - Fax:308-254-7258
Practice Address - Street 1:645 OSAGE ST
Practice Address - Street 2:SIDNEY REGIONAL MEDICAL CENTER
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162-1714
Practice Address - Country:US
Practice Address - Phone:308-254-5825
Practice Address - Fax:308-254-7258
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR036618163WC0200X
NE101240207L00000X
SDCR000918367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology