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NPI Code Detail

MEDICARE: VERONICA JEANISE MINTER RN

MEDICARE: VERONICA JEANISE MINTER RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse0001300785VA

General Provider Information

NPI Number : 1013671965
Entity Type Code : Individual
Provider Name (Legal Business Name) : VERONICA JEANISE MINTER RN
Provider Business Mailing Address
First Line : 5618 OLD GUARD CRES
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-7322
Country : US
Telephone Number : 757-355-3363
Fax Number :
Provider Business Practice Location Address
First Line : 5618 OLD GUARD CRES
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-7322
Country : US
Telephone Number : 757-355-3363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2021
Last Update Date : 10/27/2021

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