Provider Demographics
NPI:1578578043
Name:MANRING, RENEE L (NP)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:L
Last Name:MANRING
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:L
Other - Last Name:MANRING-DAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, ACNP
Mailing Address - Street 1:4 ZIA TRL
Mailing Address - Street 2:
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-9694
Mailing Address - Country:US
Mailing Address - Phone:208-284-6097
Mailing Address - Fax:
Practice Address - Street 1:3001 BROADMOOR BLVD NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-2100
Practice Address - Country:US
Practice Address - Phone:505-272-6020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209009422363LA2100X
NMCNP00477363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care