Provider Demographics
NPI:1487448064
Name:MINCEY, DEONTE CORVETTE
Entity type:Individual
Prefix:
First Name:DEONTE
Middle Name:CORVETTE
Last Name:MINCEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1682 CANYON PKWY
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-8267
Mailing Address - Country:US
Mailing Address - Phone:234-788-9166
Mailing Address - Fax:
Practice Address - Street 1:1682 CANYON PKWY
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-8267
Practice Address - Country:US
Practice Address - Phone:234-788-9166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant