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NPI Code Detail

MEDICARE: OLIVIA RENEE MINER

MEDICARE: OLIVIA RENEE MINER
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
1367H00000XAnesthesiologist AssistantIN

General Provider Information

NPI Number : 1720940109
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA RENEE MINER
Provider Business Mailing Address
First Line : 3200 SYCAMORE CT STE 1B
Second Line :
City : COLUMBUS
State : IN
Zip : 47203-1545
Country : US
Telephone Number : 812-378-9027
Fax Number : 812-378-1014
Provider Business Practice Location Address
First Line : 2400 17TH ST
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-5351
Country : US
Telephone Number : 800-841-4938
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2025
Last Update Date : 01/13/2026

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Directions to “ OLIVIA RENEE MINER ” Practice Location

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