MEDICARE: MERAV B MINKIN RN, CLC, CD (DONA)

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
1	163WL0100X	Lactation Consultant (Registered Nurse)	RN.445012	OH
2	374J00000X	Doula

General Provider Information

NPI Number	:	1194455006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERAV B MINKIN RN, CLC, CD (DONA)

Provider Business Mailing Address
First Line	:	2372 S BELVOIR BLVD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-4614
Country	:	US
Telephone Number	:	401-440-5445
Fax Number	:

Provider Business Practice Location Address
First Line	:	2372 S BELVOIR BLVD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-4614
Country	:	US
Telephone Number	:	401-440-5445
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2022
Last Update Date	:	06/14/2022

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