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NPI Code Detail

MEDICARE: MS. DOLORES ANNE MINCHHOFF CRNP

MEDICARE: MS. DOLORES ANNE MINCHHOFF CRNP
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
1363LF0000XFamily Nurse PractitionerVP005714BPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1VP005714BOTHERPALICENSE NUMBER

General Provider Information

NPI Number : 1922004068
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DOLORES ANNE MINCHHOFF CRNP
Provider Business Mailing Address
First Line : 398 MARTIC HEIGHTS DR
Second Line :
City : HOLTWOOD
State : PA
Zip : 17532-9679
Country : US
Telephone Number : 717-284-2065
Fax Number :
Provider Business Practice Location Address
First Line : 620 SPEAR ST
Second Line :
City : OXFORD
State : PA
Zip : 19363-1655
Country : US
Telephone Number : 610-932-9300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 07/01/2010

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