Healthcare Provider Details

I. General information

NPI: 1992686380
Provider Name (Legal Business Name): JULIE TAYLOR-MINERVINI RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE TAYLOR-MINERVINI RN, BSN

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2464 FORTUNE DR STE 110
LEXINGTON KY
40509-4254
US

IV. Provider business mailing address

510 MANNING RD
STANTON KY
40380-9745
US

V. Phone/Fax

Practice location:
  • Phone: 954-558-1966
  • Fax:
Mailing address:
  • Phone: 954-558-1966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number1141609
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: