Provider Demographics
NPI:1710744412
Name:MINANI, MARIE E (MPHNP-BC)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:E
Last Name:MINANI
Suffix:
Gender:F
Credentials:MPHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 W WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-0110
Mailing Address - Country:US
Mailing Address - Phone:919-757-4941
Mailing Address - Fax:
Practice Address - Street 1:1011 W WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-0110
Practice Address - Country:US
Practice Address - Phone:919-757-4941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC297960363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health