Healthcare Provider Details

I. General information

NPI: 1548251804
Provider Name (Legal Business Name): MINEA ANN READYE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USAG-J UNIT 45013 BOX 2088
APO AP
96338
JP

IV. Provider business mailing address

USAG-J UNIT 45013 BOX 2088
APO AP
96338
JP

V. Phone/Fax

Practice location:
  • Phone: 0011813117634249
  • Fax:
Mailing address:
  • Phone: 0011813117634249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License Number094738
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: