Provider Demographics
NPI:1043835903
Name:HONOR MOBILE HEALTHCARE PLLC
Entity Type:Organization
Organization Name:HONOR MOBILE HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:JOANN
Authorized Official - Last Name:MINKO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:608-206-5479
Mailing Address - Street 1:7786 RIDGELAKE CIR
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-2509
Mailing Address - Country:US
Mailing Address - Phone:941-828-5199
Mailing Address - Fax:941-761-6188
Practice Address - Street 1:7786 RIDGELAKE CIR
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-2509
Practice Address - Country:US
Practice Address - Phone:941-828-5199
Practice Address - Fax:941-761-6188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty