Healthcare Provider Details

I. General information

NPI: 1932829322
Provider Name (Legal Business Name): ROBIN LEE MINCHER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 08/29/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 N CENTRAL AVE
PHOENIX AZ
85012-2501
US

IV. Provider business mailing address

3300 N CENTRAL AVE
PHOENIX AZ
85012-2501
US

V. Phone/Fax

Practice location:
  • Phone: 602-427-2370
  • Fax:
Mailing address:
  • Phone: 602-427-2370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN062946
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: