Active NPI
Maricon Manalac
- Registered Nurse
- Agana Heights, GU
National Provider Identifier
1407600232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RX0994
- Practice address
- 498 Chalan Palasyo
Agana Heights, GU 96910 - Phone
- (671) 475-5760
- NPI assigned
- Apr 17, 2024
- Last updated
- Apr 17, 2024
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RX0994 | GU | Primary |
Addresses
Primary practice location
498 Chalan Palasyo
Agana Heights, GU 96910
Mailing address
1779 Army Drive PMB 278 Suite 105
Tamuning, GU 96913
Phone (671) 486-2961
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 |
|---|---|---|---|
| RX0994 | GU | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713312000000",
"number": "1407600232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1779 ARMY DRIVE PMB 278 SUITE 105",
"city": "TAMUNING",
"state": "GU",
"postal_code": "96913",
"telephone_number": "671-486-2961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "498 CHALAN PALASYO",
"city": "AGANA HEIGHTS",
"state": "GU",
"postal_code": "96910",
"telephone_number": "671-475-5760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANALAC",
"first_name": "MARICON",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-17",
"last_updated": "2024-04-17",
"certification_date": "2024-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "GU",
"license": "RX0994",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Agana Heights, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.