Individual
MS. JOHNETTA MINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
140 DARROW PL, SUITE 16B, BRONX, NY 10475-1802
(718) 379-1290
(718) 379-8597
Mailing address
140 DARROW PL, SUITE 16B, BRONX, NY 10475-1802
(718) 379-1290
(718) 379-8597
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F420329-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02241798
—
NY
Enumeration date
10/22/2005
Last updated
10/27/2010
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