Healthcare Provider Details

I. General information

NPI: 1790083251
Provider Name (Legal Business Name): DANIELLE MINCH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE BARTLEY

II. Dates (important events)

Enumeration Date: 03/08/2011
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 MAIN ST STE 104
WHEELING WV
26003-2737
US

IV. Provider business mailing address

1005 WHITE WILLOW WAY
MORGANTOWN WV
26505-6119
US

V. Phone/Fax

Practice location:
  • Phone: 304-513-3495
  • Fax: 800-734-8498
Mailing address:
  • Phone: 304-513-3495
  • Fax: 800-734-8498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.12258
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN56541
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: