Individual
INGRID MINOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
110 ROY KIDD AVE, CORBIN, KY 40701-1302
(606) 528-7400
(606) 528-7449
Mailing address
PO BOX 545, CORBIN, KY 40702-0545
(606) 528-7400
(606) 528-7449
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA841
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000605852
ANTHEM
KY
05
—
95004826
—
KY
Enumeration date
05/05/2006
Last updated
06/09/2009
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