Active NPI
Edra Manzo
- Family Nurse Practitioner
- El Paso, TX
National Provider Identifier
1306505300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1058636
- Practice address
- 1801 Murchinson Dr.
El Paso, TX 79902 - Phone
- (214) 751-2708
- NPI assigned
- Dec 17, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1058636 | TX | Primary |
Addresses
Primary practice location
1801 Murchinson Dr.
El Paso, TX 79902
Mailing address
6725 Desert Canyon Dr
El Paso, TX 79912-7604
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1058636 | TX | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639699200000",
"number": "1306505300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6725 DESERT CANYON DR",
"city": "EL PASO",
"state": "TX",
"postal_code": "799127604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 MURCHINSON DR.",
"city": "EL PASO",
"state": "TX",
"postal_code": "79902",
"telephone_number": "214-751-2708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANZO",
"first_name": "EDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-17",
"last_updated": "2021-12-17",
"certification_date": "2021-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "1058636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
- Manual Physical Therapy Specialists LLC
- Manuel D Lopez MD PA
- Manuel F Valenzuela Mdpa
- Manuel J. Palafox, D.O., P.a
- Zachary Daniel Manzo-Micoletti, PA-C
- Francesco Giuseppe Maoli, MD
- Edward Mapula, D.D.S.
- Joseph M Mapula, R.PH.
- Maranatha Physical Medicine & Rehabilitation, PLLC
- Marble Rose Enterprises LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.