Provider Demographics
NPI:1710710199
Name:MCMANUS, MICHELLE CHRISTINA (RDN)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:CHRISTINA
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:CHRISTINA
Other - Last Name:DANDREA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:3143 ROSEMONT WAY
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-9481
Mailing Address - Country:US
Mailing Address - Phone:406-690-1909
Mailing Address - Fax:
Practice Address - Street 1:3143 ROSEMONT WAY
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-9481
Practice Address - Country:US
Practice Address - Phone:406-690-1909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-21
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT133VN1005X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered