Individual provider Active NPI

Gifty Serwah Manu

  • Psychiatric/Mental Health Registered Nurse
  • Grand Prairie, TX
National Provider Identifier
1396579355
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
1171967 Issued in TX
Practice address
2651 Bridgewater Dr
Grand Prairie, TX 75054-7229
Phone
(817) 991-6230
NPI assigned
Aug 30, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 1171967 TX Primary

Addresses

Primary practice location

2651 Bridgewater Dr
Grand Prairie, TX 75054-7229

Mailing address

2651 Bridgewater Dr
Grand Prairie, TX 75054-7229
Phone (817) 991-6230

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

LicenseStateTypeSpecialty
1171967TXMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1724976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1396579355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2651 BRIDGEWATER DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750547229",
            "telephone_number": "817-991-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 BRIDGEWATER DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750547229",
            "telephone_number": "817-991-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANU",
        "first_name": "GIFTY",
        "middle_name": "SERWAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-30",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1171967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.