Provider Demographics
NPI:1316258155
Name:MINTA, CATHERINE KYEI (LPN)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:KYEI
Last Name:MINTA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MERLIN DR
Mailing Address - Street 2:APT. D
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-7162
Mailing Address - Country:US
Mailing Address - Phone:513-829-2404
Mailing Address - Fax:
Practice Address - Street 1:22 MERLIN DR
Practice Address - Street 2:APT. D
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-7162
Practice Address - Country:US
Practice Address - Phone:513-829-2404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-26
Last Update Date:2010-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN- 123035164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse