Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 2001005627 | MO |
N | 207V00000X | Obstetrician & Gynecologist | 28036 | NE |
Y | 207VX0000X | Obstetrician | MD-43345 | IA |
NPI | 1245255934 |
---|---|
Provider Name | Dr. Maureen A Boyle-Manganaro |
First Address | Omaha, NE 68103-0755 |
Second Address | Council Bluffs, IA 51503-4643 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 07/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10001545401 | COMMUNITY HEALTH PLAN (01) | |
10026211300 | (05) | NE |
10026301600 | (05) | NE |
100402030B | (05) | KS |
1245255934 | (05) | IA |
29689029 | BLUE CROSS BLUE SHIELD (01) | MO |
414770 | FIRSTGUARD (01) | |
44054528964506V018 | TRICARE/CHAMPUS (01) | |
465449 | CHILDRENS MERCY FAMILY HEALTH (01) | MO |
47068731777 | (05) | NE |
476709 | HEALTHLINK (01) | |
5897653 | AETNA (01) | |
H43210 | (02) | |
P00036242 | RAILROAD MEDICARE (01) |