Provider Demographics
NPI:1134348188
Name:MINTER, KARLA JEAN (MPH, RD, CD)
Entity type:Individual
Prefix:MS
First Name:KARLA
Middle Name:JEAN
Last Name:MINTER
Suffix:
Gender:F
Credentials:MPH, RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20111 REGINA RD
Mailing Address - Street 2:
Mailing Address - City:NEW PARIS
Mailing Address - State:IN
Mailing Address - Zip Code:46553-9632
Mailing Address - Country:US
Mailing Address - Phone:574-202-0704
Mailing Address - Fax:574-831-6795
Practice Address - Street 1:20111 REGINA RD
Practice Address - Street 2:
Practice Address - City:NEW PARIS
Practice Address - State:IN
Practice Address - Zip Code:46553-9632
Practice Address - Country:US
Practice Address - Phone:574-202-0704
Practice Address - Fax:574-831-6795
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37000537A133V00000X, 133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Not Answered133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric