Provider Demographics
NPI:1629777354
Name:MINKARA, DIALA A (APRN)
Entity Type:Individual
Prefix:
First Name:DIALA
Middle Name:A
Last Name:MINKARA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6845 MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6561
Mailing Address - Country:US
Mailing Address - Phone:423-910-0896
Mailing Address - Fax:
Practice Address - Street 1:93 ROBIN RD
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2415
Practice Address - Country:US
Practice Address - Phone:706-861-4508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33536207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology