Individual
TAMARA S MINNIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
41769
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720975
BCBS
WV
05
—
0068794000
—
WV
05
—
0892851
—
OH
01
—
1067623
WORKERS' COMP
WV
05
—
74430216
—
KY
Enumeration date
10/18/2006
Last updated
06/08/2009
Update your record
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