Individual
IVAN MINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
500 LIMIT ST, LEAVENWORTH, KS 66048-4435
(913) 682-5118
Mailing address
500 LIMIT ST, LEAVENWORTH, KS 66048-4435
(913) 682-5118
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
65845
KS
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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