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NPI Code Detail

MEDICARE: MRS. KATHERINE SUE MINARCHECK CPNP

MEDICARE: MRS. KATHERINE SUE MINARCHECK CPNP
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
1363L00000XNurse PractitionerCOA.08454-NPOH

General Provider Information

NPI Number : 1235191578
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHERINE SUE MINARCHECK CPNP
Provider Business Mailing Address
First Line : 1 PERKINS SQ
Second Line :
City : AKRON
State : OH
Zip : 44308-1063
Country : US
Telephone Number : 330-478-0038
Fax Number : 330-477-1383
Provider Business Practice Location Address
First Line : 125 WHIPPLE AVE SW
Second Line :
City : CANTON
State : OH
Zip : 44710-1374
Country : US
Telephone Number : 330-478-0038
Fax Number : 330-477-1383
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2006
Last Update Date : 08/09/2016

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