Provider Demographics
NPI:1992448617
Name:MINER, ANITA MARIE
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:MARIE
Last Name:MINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 ROCKY RILL CT
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44904-1835
Mailing Address - Country:US
Mailing Address - Phone:614-581-6564
Mailing Address - Fax:
Practice Address - Street 1:1715 ROCKY RILL CT
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44904-1835
Practice Address - Country:US
Practice Address - Phone:614-581-6564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker