Individual
EDITH SUSAN MINKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
105 WEBSTER ST, STE 8, HANOVER, MA 02339-1227
(781) 754-6545
Mailing address
105 WEBSTER ST, STE 8, HANOVER, MA 02339-1227
(781) 754-6545
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
149267
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110091463A
—
MA
Enumeration date
01/30/2007
Last updated
09/08/2016
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