Provider Demographics
NPI:1164024063
Name:MINGES, COLLEEN AMBER
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:AMBER
Last Name:MINGES
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 1:1051 WEAVER RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-7538
Mailing Address - Country:US
Mailing Address - Phone:513-839-3040
Mailing Address - Fax:
Practice Address - Street 1:3011 HAMILTON SCIPIO RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-9641
Practice Address - Country:US
Practice Address - Phone:513-839-3040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-15
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0000266370374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0000266370OtherDODD SUPPLIER ID