Provider Demographics
NPI:1255808044
Name:MINNIFIELD, YASMINE MARIE
Entity type:Individual
Prefix:
First Name:YASMINE
Middle Name:MARIE
Last Name:MINNIFIELD
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 1:5742 GLORE DR SW
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-3462
Mailing Address - Country:US
Mailing Address - Phone:678-510-3769
Mailing Address - Fax:
Practice Address - Street 1:5742 GLORE DR SW
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-3462
Practice Address - Country:US
Practice Address - Phone:678-510-3769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula