Provider Demographics
NPI:1417397456
Name:MINGER, BOBBIJO P X
Entity Type:Individual
Prefix:
First Name:BOBBIJO
Middle Name:P
Last Name:MINGER
Suffix:X
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 1:105 S MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-2363
Mailing Address - Country:US
Mailing Address - Phone:330-581-8093
Mailing Address - Fax:
Practice Address - Street 1:105 S MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-2363
Practice Address - Country:US
Practice Address - Phone:330-581-8093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH373729900394376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide