Healthcare Provider Details

I. General information

NPI: 1609781723
Provider Name (Legal Business Name): REASE JOAN MINNIEAR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N RITTER AVE
INDIANAPOLIS IN
46219-3027
US

IV. Provider business mailing address

407 CANAL VIEW CIR APT J APT J
INDIANAPOLIS IN
46202-6136
US

V. Phone/Fax

Practice location:
  • Phone: 317-355-5457
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number28266481A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: