Provider Demographics
NPI:1982971487
Name:MINKLER, KIMBERLY ERIN (NP)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ERIN
Last Name:MINKLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 S TRANSIT ST STE 104
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-4836
Mailing Address - Country:US
Mailing Address - Phone:716-514-4042
Mailing Address - Fax:
Practice Address - Street 1:231 S TRANSIT ST STE 104
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-4836
Practice Address - Country:US
Practice Address - Phone:716-514-4042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN198812363L00000X
NY349059363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner