Provider Demographics
NPI:1447683594
Name:MCMANUS, MEGAN DEBELL (NP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:DEBELL
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 GARNER RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-6666
Mailing Address - Country:US
Mailing Address - Phone:919-556-1008
Mailing Address - Fax:919-556-6099
Practice Address - Street 1:1500 GARNER RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610
Practice Address - Country:US
Practice Address - Phone:919-556-1008
Practice Address - Fax:919-556-6099
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006367363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCMM2972924OtherDEA