Provider Demographics
NPI:1114340767
Name:MINTER, ANNETTE EASLEY (AG-ACNP)
Entity Type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:EASLEY
Last Name:MINTER
Suffix:
Gender:F
Credentials:AG-ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 RISON ST STE 120
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-2426
Mailing Address - Country:US
Mailing Address - Phone:434-792-3730
Mailing Address - Fax:434-792-6048
Practice Address - Street 1:501 RISON ST STE 120
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-2426
Practice Address - Country:US
Practice Address - Phone:434-792-3730
Practice Address - Fax:434-792-6048
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171370363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care