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NPI Code Detail

MEDICARE: KATHERINE MINNICUCCI RN

MEDICARE: KATHERINE MINNICUCCI RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse506465CA

General Provider Information

NPI Number : 1407253958
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE MINNICUCCI RN
Provider Business Mailing Address
First Line : 6222 HAMSHIRE DR
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92647-6455
Country : US
Telephone Number : 714-848-1744
Fax Number :
Provider Business Practice Location Address
First Line : 501 THE CITY DR S
Second Line :
City : ORANGE
State : CA
Zip : 92868-3305
Country : US
Telephone Number : 714-848-1744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2014
Last Update Date : 11/28/2014

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Directions to “ KATHERINE MINNICUCCI RN” Practice Location

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