Individual provider · Type 1 NPI

Johnnjalyn Shataun Manning, APRN-BC

Family Nurse Practitioner · Fort Worth, TX

NPI number 1104714278 Active

Practice location

1500 S Main St
Fort Worth, TX 76104-4917

Call (817) 702-1100 Map

Mailing address

200 W Magnolia Ave Ste 201
Fort Worth, TX 76104-7657

Specialties and licenses

Taxonomy	Code	License
Family Nurse Practitioner Primary	363LF0000X	1210013 (TX)

Family Nurse Practitioner: Definition to come...

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About NPI 1104714278

Johnnjalyn Shataun Manning, APRN-BC's National Provider Identifier is 1104714278, issued on Jun 26, 2025. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Fort Worth, TX. The record was last updated on Aug 25, 2025.