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General NPI Number Information
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NPI Number | 1073356143
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Entity Type | Individual
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Provider Name | ESRA MINNITI RN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/17/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 1471 CHESTER BLVD
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City | RICHMOND
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State | IN
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Zip | 47374-1945
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Country | US
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Telephone | 765-983-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 REID HEALTH MEDICAL STAFF SERVICES
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City | RICHMOND
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State | IN
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Zip | 47374
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Country | US
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Telephone | 765-935-8802
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28237246A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71015841A
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License Number State | IN
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