Provider Demographics
NPI:1578321279
Name:MINNER, LORI (STNA)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:MINNER
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:MICHELLE
Other - Last Name:TSCHIEGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:STNA
Mailing Address - Street 1:995 BARBADOS AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-1957
Mailing Address - Country:US
Mailing Address - Phone:330-317-6144
Mailing Address - Fax:
Practice Address - Street 1:995 BARBADOS AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-1957
Practice Address - Country:US
Practice Address - Phone:330-317-6144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty