Provider Demographics
NPI:1124725528
Name:MINTER, ZAMARI
Entity type:Individual
Prefix:
First Name:ZAMARI
Middle Name:
Last Name:MINTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 E RAY RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-7118
Mailing Address - Country:US
Mailing Address - Phone:622-721-7403
Mailing Address - Fax:
Practice Address - Street 1:8165 E INDIAN BEND RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-4829
Practice Address - Country:US
Practice Address - Phone:662-721-7403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician