Provider Demographics
NPI:1912539313
Name:MINOR, MEGHAN LYNSEY
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:LYNSEY
Last Name:MINOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 SANDRA DR
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70714-4005
Mailing Address - Country:US
Mailing Address - Phone:225-620-2896
Mailing Address - Fax:
Practice Address - Street 1:509 SANDRA DR
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714-4005
Practice Address - Country:US
Practice Address - Phone:225-620-2896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator