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General NPI Number Information
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NPI Number | 1760515134
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Entity Type | Individual
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Provider Name | LUCIA ANN MINVIELLE NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10 N GREENE ST
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City | BALTIMORE
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State | MD
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Zip | 21201-1524
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Country | US
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Telephone | 410-605-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 764 BON HAVEN DR
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7133
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Country | US
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Telephone | 410-980-6070
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN36700APO1169
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License Number State | LA
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