Provider Demographics
NPI:1083268379
Name:MINOR, KASHINA (LPN)
Entity Type:Individual
Prefix:
First Name:KASHINA
Middle Name:
Last Name:MINOR
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 1:464 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2792
Mailing Address - Country:US
Mailing Address - Phone:216-298-7384
Mailing Address - Fax:
Practice Address - Street 1:464 RICHMOND RD STE 202
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-2704
Practice Address - Country:US
Practice Address - Phone:440-479-2236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.170115164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse