Provider Demographics
NPI:1598560955
Name:MINOR, PIERRE FANTES
Entity type:Individual
Prefix:
First Name:PIERRE
Middle Name:FANTES
Last Name:MINOR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11025 M ST APT 805
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2353
Mailing Address - Country:US
Mailing Address - Phone:773-899-4772
Mailing Address - Fax:
Practice Address - Street 1:11025 M ST APT 805
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2353
Practice Address - Country:US
Practice Address - Phone:773-899-4772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty