Individual
KATIE MINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
3301 N OAK STREET EXT, VALDOSTA, GA 31605-1014
(229) 242-6061
(229) 242-6151
Mailing address
3301 N OAK STREET EXT, VALDOSTA, GA 31605
(229) 242-6061
(229) 242-6151
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
140594
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000954236D
—
GA
Enumeration date
06/28/2006
Last updated
06/20/2019
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