Individual
SHANITA MINOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1123 N 63RD ST, PHILADELPHIA, PA 19151-3209
(215) 650-7767
Mailing address
403 ZAMORA CT, TOWNSEND, DE 19734-3054
(267) 216-6113
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN678707
PA
Other
Enumeration date
11/03/2021
Last updated
11/03/2021
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