Provider Demographics
NPI:1013671965
Name:MINTER, VERONICA JEANISE (RN)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:JEANISE
Last Name:MINTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5618 OLD GUARD CRES
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7322
Mailing Address - Country:US
Mailing Address - Phone:757-355-3363
Mailing Address - Fax:
Practice Address - Street 1:5618 OLD GUARD CRES
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-7322
Practice Address - Country:US
Practice Address - Phone:757-355-3363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001300785163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse