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NPI Code Detail

MEDICARE: MRS. EBONY LYNNELL MINTER APRN

MEDICARE: MRS. EBONY LYNNELL MINTER APRN
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 Nurse361937OH
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN.CNP.0037450OH

General Provider Information

NPI Number : 1598055246
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EBONY LYNNELL MINTER APRN
Provider Business Mailing Address
First Line : 26600 RENAISSANCE PKWY
Second Line :
City : CLEVELAND
State : OH
Zip : 44128-5795
Country : US
Telephone Number : 216-306-0209
Fax Number :
Provider Business Practice Location Address
First Line : 26600 RENAISSANCE PKWY
Second Line :
City : WARRENSVILLE HEIGHTS
State : OH
Zip : 44128-5795
Country : US
Telephone Number : 216-306-0209
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2011
Last Update Date : 02/26/2025

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