Nicole Manchak, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

278085 Issued in AZ

Practice address

143 E Germann Rd # B101
Gilbert, AZ 85297-0607

Phone

(480) 304-0249

NPI assigned

Jul 20, 2022

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1811622178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 E SOUTHERN AVE STE 101",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825215",
            "telephone_number": "480-281-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 E GERMANN RD # B101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970607",
            "telephone_number": "480-304-0249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "426 E Southern Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852825215",
            "country_code": "US",
            "telephone_number": "480-681-7979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCHAK",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "278085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vani Malladi
• Renee Mallory
• Samantha Malmin
• Lauri Neil Malolo, B.A., R.D.H.
• Jody J Maluski, PT
• Yogya Sreeharshini Mandali, PHARMD
• Lora A Mangiafico, PA-C
• Lauren Kay Manion
• Mariano Vittorio Maniscalco, DO
• James A Mankin, M.D.

• Family Nurse Practitioner in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.