Mistie Sue Manning, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

6926945-4405 Issued in UT

Practice address

1551 Renaissance Towne Dr Ste 370
Bountiful, UT 84010-7675

Phone

(801) 747-7244

NPI assigned

Oct 23, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Granger Medical Clinic PC

  • Multi-Specialty Clinic/Center
  • West Valley City, UT
  • NPI 1184657041
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1164021721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 RENAISSANCE TOWNE DR STE 370",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107675",
            "telephone_number": "801-747-7244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 RENAISSANCE TOWNE DR STE 370",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107675",
            "telephone_number": "801-747-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "MISTIE",
        "middle_name": "SUE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "6926945-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Manley, PSYD
• Nicholas Mann
• Manning Behavior Services, LLC
• Manning Facial Plastic Surgery
• Christine Manning
• Robyn Manning
• Jessica Mansell
• Elizabeth Mantanona
• Todd Reece Manwaring, MSW, LCSW
• Brianda Marin

• Family Nurse Practitioner in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.