Provider Demographics
NPI:1164103719
Name:UFFMAN, MINNIE JO (CPSS)
Entity Type:Individual
Prefix:
First Name:MINNIE
Middle Name:JO
Last Name:UFFMAN
Suffix:
Gender:F
Credentials:CPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 LANGDON ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-2392
Mailing Address - Country:US
Mailing Address - Phone:606-310-4945
Mailing Address - Fax:
Practice Address - Street 1:80 HIGHWAY 2227
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-1562
Practice Address - Country:US
Practice Address - Phone:606-485-4003
Practice Address - Fax:606-485-4050
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1207168175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist