Provider Demographics
NPI:1164310827
Name:MANNS, ROBERT VAUGHN II
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:VAUGHN
Last Name:MANNS
Suffix:II
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 COLEMAN HL
Mailing Address - Street 2:
Mailing Address - City:WEST HAMLIN
Mailing Address - State:WV
Mailing Address - Zip Code:25571-8022
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35 COLEMAN HL
Practice Address - Street 2:
Practice Address - City:WEST HAMLIN
Practice Address - State:WV
Practice Address - Zip Code:25571-8022
Practice Address - Country:US
Practice Address - Phone:304-633-7514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide