Healthcare Provider Details

I. General information

NPI: 1609758515
Provider Name (Legal Business Name): EVE MINNIS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EXECUTIVE PARK STE 103
LOUISVILLE KY
40207-4201
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7725
US

V. Phone/Fax

Practice location:
  • Phone: 888-585-8434
  • Fax: 216-456-8128
Mailing address:
  • Phone: 888-585-8434
  • Fax: 216-456-8128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4063354
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: