Provider Demographics
NPI:1710744412
Name:MINANI, MARIE E (MPHNP-BC)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:E
Last Name:MINANI
Suffix:
Gender:F
Credentials:MPHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 BARRETT DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7224
Mailing Address - Country:US
Mailing Address - Phone:919-870-8409
Mailing Address - Fax:877-622-8953
Practice Address - Street 1:3801 BARRETT DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7224
Practice Address - Country:US
Practice Address - Phone:919-870-8409
Practice Address - Fax:877-622-8953
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC297960363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health