Individual
SHAUNNA F MINNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5907 COVINGTON RD STE E, FORT WAYNE, IN 46804-5867
(317) 650-9031
Mailing address
5907 COVINGTON RD STE E, FORT WAYNE, IN 46804-5867
(317) 650-9031
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28213789A
IN
Other
Enumeration date
10/13/2023
Last updated
10/13/2023
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