Provider Demographics
NPI:1174763999
Name:MINOR, MONICA L (LPN)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:L
Last Name:MINOR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4564 SHAWNRAY DR
Mailing Address - Street 2:APT 152
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-2313
Mailing Address - Country:US
Mailing Address - Phone:513-594-6800
Mailing Address - Fax:
Practice Address - Street 1:4564 SHAWNRAY DR
Practice Address - Street 2:APT 152
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-2313
Practice Address - Country:US
Practice Address - Phone:513-594-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 108744164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse