Provider Demographics
NPI:1508246802
Name:MINTER, VICKIE (PHELBOTOMIST)
Entity Type:Individual
Prefix:
First Name:VICKIE
Middle Name:
Last Name:MINTER
Suffix:
Gender:F
Credentials:PHELBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:789 ROSSER RD
Mailing Address - Street 2:
Mailing Address - City:BEAR CREEK
Mailing Address - State:NC
Mailing Address - Zip Code:27207-9667
Mailing Address - Country:US
Mailing Address - Phone:919-218-5603
Mailing Address - Fax:
Practice Address - Street 1:789 ROSSER RD
Practice Address - Street 2:
Practice Address - City:BEAR CREEK
Practice Address - State:NC
Practice Address - Zip Code:27207-9667
Practice Address - Country:US
Practice Address - Phone:919-218-5603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy