Provider Demographics
NPI:1457811424
Name:MINOR, MELINDA MARIE (PERSONAL CAREGIVER)
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:MARIE
Last Name:MINOR
Suffix:
Gender:F
Credentials:PERSONAL CAREGIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1838 HARVARD ST APT B
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-6781
Mailing Address - Country:US
Mailing Address - Phone:702-203-7023
Mailing Address - Fax:
Practice Address - Street 1:1838 HARVARD ST APT B
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-6781
Practice Address - Country:US
Practice Address - Phone:702-203-7023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker