Provider Demographics
NPI:1194455006
Name:MINKIN, MERAV B (RN, CLC, CD (DONA))
Entity Type:Individual
Prefix:
First Name:MERAV
Middle Name:B
Last Name:MINKIN
Suffix:
Gender:F
Credentials:RN, CLC, CD (DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2372 S BELVOIR BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-4614
Mailing Address - Country:US
Mailing Address - Phone:401-440-5445
Mailing Address - Fax:
Practice Address - Street 1:2372 S BELVOIR BLVD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-4614
Practice Address - Country:US
Practice Address - Phone:401-440-5445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.445012163WL0100X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant