Provider Demographics
NPI:1629618616
Name:MINCH, JULIE D (CRNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:D
Last Name:MINCH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 LUCINA AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15210-4136
Mailing Address - Country:US
Mailing Address - Phone:412-932-8001
Mailing Address - Fax:
Practice Address - Street 1:127 ANDERSON ST STE 101
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-5803
Practice Address - Country:US
Practice Address - Phone:412-322-4151
Practice Address - Fax:844-341-1405
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020799363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily