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General NPI Number Information
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NPI Number | 1609271576
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Entity Type | Individual
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Provider Name | KATY MINGA APRN
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Gender | Female
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Dates
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Enumeration Date | 11/04/2014
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Last Update Date | 08/26/2019
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Provider Practice Location Address
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Address Line | 100 BAPTIST MEMORIAL CIR STE 200
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City | OXFORD
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State | MS
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Zip | 38655-4476
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Country | US
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Telephone | 662-636-2450
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Fax |
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Provider Business Mailing Address
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Address Line | 965 RIDGE LAKE BLVD STE 103
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City | MEMPHIS
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State | TN
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Zip | 38120-9446
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R885511
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License Number State | MS
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