Provider Demographics
NPI:1720244072
Name:MINK, VICKIE (RN,BSN)
Entity Type:Individual
Prefix:MS
First Name:VICKIE
Middle Name:
Last Name:MINK
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 DANVERS DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-3108
Mailing Address - Country:US
Mailing Address - Phone:513-693-7759
Mailing Address - Fax:
Practice Address - Street 1:780 DANVERS DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-3108
Practice Address - Country:US
Practice Address - Phone:513-693-7759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.308048163WC0400X
OHRN308048163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management