KELLY ANDREA MANZ (NPI# 1043858400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043858400 |
| Entity Type | Individual |
| Full Name | KELLY ANDREA MANZ |
| Practice Address |
1592 Monroe St North Bend OR 97459-3657 |
| Mailing Address |
3587 Heathrow Way Medford OR 97504-4004 |
| Practice Telephone | 5417562048 |
| Practice Fax Number | 5417562058 |
| Mailing Telephone | 5418588170 |
| Mailing Fax Number | 5418588164 |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2019-12-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
201901765RN | OR | Nursing Service Providers |
| Street Address |
1592 MONROE ST |
| City | NORTH BEND |
| State | OR |
| Zip Code | 97459-3657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386787596 | Columbiacare Services | Psychiatric Residential Treatment Facility | 1592 Monroe St, North Bend, OR 97459-3657 | 2007-02-15 |
| 1225650351 | Gregory Lynn Glass | Counselor | 1592 Monroe St, North Bend, OR 97459-3657 | 2020-05-12 |
| 1548806102 | Rosealee May Selfors | Counselor | 1592 Monroe St, North Bend, OR 97459-3657 | 2019-11-19 |
| 1639736044 | Kitina L Larsen | Counselor | 1592 Monroe St, North Bend, OR 97459-3657 | 2019-05-21 |
| 1710540760 | Marcia Heinzman | Counselor | 1592 Monroe St, North Bend, OR 97459-3657 | 2019-04-16 |
| 1285102129 | Carleen Hawthorne | Counselor | 1592 Monroe St, North Bend, OR 97459-3657 | 2018-11-08 |
| 1801362322 | Kimberly E Riddle | Counselor | 1592 Monroe St, North Bend, OR 97459-3657 | 2018-10-23 |
| 1447733092 | Jermiah G Hansen | Counselor | 1592 Monroe St, North Bend, OR 97459-3657 | 2018-09-10 |
| 1467969816 | Morina A Vonk | Counselor | 1592 Monroe St, North Bend, OR 97459-3657 | 2018-01-08 |
| 1427562933 | Shannon Loraine Durkee | Counselor | 1592 Monroe St, North Bend, OR 97459-3657 | 2017-11-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568002749 | Ya-chi Claire Chang | Nurse Practitioner | 1229 1890 Waite St #1, North Bend, OR 97459 | 2020-01-15 |
| 1629573977 | Heather M Coates | Counselor | 400 Virginia Ave Ste 100, North Bend, OR 97459 | 2018-03-28 |
| 1205257219 | Melissa Sperry | Health Educator | 510 Lockhart Street, North Bend, OR 97459 | 2013-12-17 |
| 1265862627 | Elizabeth Sylvester | Counselor | 1592 Monroe Street, North Bend, OR 97459 | 2013-11-22 |
| 1124370291 | Brian Noble Thompson | Pharmacist | 3411 Broadway St., North Bend, OR 97459 | 2012-10-12 |
| 1295081230 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3411 Broadway St, North Bend, OR 97459 | 2012-07-27 |
| 1366728370 | Melissa Jean Kovach | Occupational Therapy Assistant | 3959 Sheridan Ave., North Bend, OR 97459 | 2011-10-24 |
| 1295045052 | Mary Kay Weikel | Massage Therapist | 3229 Broadway St Suite G Serenity Therapy Center, North Bend, OR 97459 | 2010-10-14 |
| 1902080013 | Anthony Eugene Baldacci | Registered Nurse | 1836 Meade Street, North Bend, OR 97459 | 2007-12-26 |
| 1952595340 | Inland Point Senior Estates Jv LLC | Clinic/Center | 2265 Inland Drive, North Bend, OR 97459 | 2007-08-29 |
| Find all providers in zip 97459 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841284916 | Joanne Rutland | Registered Nurse | 1975 Mcpherson St, Suite 2, North Bend, OR 97459-3482 | 2005-09-06 |
| 1659608206 | Jeffrey Lee Clausen | Registered Nurse | 1975 Mcpherson St, Suite 2, North Bend, OR 97459-3482 | 2009-11-03 |
| 1912118670 | Ruth Anderson | Registered Nurse | 1975 Mcpherson St, Suite 2, North Bend, OR 97459-3482 | 2007-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932747607 | Kendall Clayton Karch | Registered Nurse | 30 Ne Mlk Jr Blvd, Portland, OR 97232-2941 | 2019-12-12 |
| 1003315045 | Ryan Tateishi | Registered Nurse | 966 12th St Se Ste 110, Salem, OR 97302-2860 | 2018-02-05 |
| 1952815532 | Shane Martin | Registered Nurse | 2110 Augusta St, Eugene, OR 97403-2202 | 2017-11-19 |
| 1811349160 | Aleksey Maksimov | Registered Nurse | 4757 Parkview Dr Apt B, Lake Oswego, OR 97035-2426 | 2016-07-11 |
| 1366832461 | Maria Liotta Shindler | Registered Nurse | 6201 Ne Carillion Dr, Hillsboro, OR 97124-8590 | 2015-01-27 |
| 1346651882 | Holly Marie Matthews | Registered Nurse | 788 Saint Charles Pl, Hood River, OR 97031-8785 | 2014-05-19 |
| 1376987404 | Helen Erika Horst | Registered Nurse | 2020 State Rd, Mosier, OR 97040 | 2013-04-19 |
| 1598013997 | Trina Marie Espiasse | Registered Nurse | 47940 Sw Ihrig Rd, Forest Grove, OR 97116-7329 | 2012-08-16 |
| 1275810665 | Esther Gabrielle Rosengarten | Registered Nurse | 1020 Sw Taylor St Ste 745, Portland, OR 97205-2505 | 2011-11-14 |
| 1336436823 | Susan Elizabeth Stone | Registered Nurse | 19333 Sw Laurelhurst Way, Bend, OR 97702-3192 | 2011-07-05 |
| Find all providers with the same taxonomy | ||||
| City | NORTH BEND |
| Zip Code | 97459 |
Please comment or provide details below to improve the information on KELLY ANDREA MANZ.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.