Provider Demographics
NPI:1114752102
Name:MINNIFIELD, RAYNISE M (STNA)
Entity type:Individual
Prefix:
First Name:RAYNISE
Middle Name:M
Last Name:MINNIFIELD
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1931 MILLVALE CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45225-1210
Mailing Address - Country:US
Mailing Address - Phone:513-280-1691
Mailing Address - Fax:
Practice Address - Street 1:1931 MILLVALE CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45225-1210
Practice Address - Country:US
Practice Address - Phone:513-280-1691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider