Provider Demographics
NPI:1669365714
Name:MINSHALL, ANGELA LYNN
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:LYNN
Last Name:MINSHALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:OH
Mailing Address - Zip Code:45779-5231
Mailing Address - Country:US
Mailing Address - Phone:740-508-1243
Mailing Address - Fax:740-508-1243
Practice Address - Street 1:1241 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:OH
Practice Address - Zip Code:45779-5231
Practice Address - Country:US
Practice Address - Phone:740-508-1243
Practice Address - Fax:740-508-1243
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health