Provider Demographics
NPI:1144852427
Name:MINOR, TRINA ELIZABETH
Entity type:Individual
Prefix:
First Name:TRINA
Middle Name:ELIZABETH
Last Name:MINOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 W BAGLEY RD APT 709
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-1999
Mailing Address - Country:US
Mailing Address - Phone:216-785-0693
Mailing Address - Fax:
Practice Address - Street 1:55 W BAGLEY RD APT 709
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:OH
Practice Address - Zip Code:44017-1999
Practice Address - Country:US
Practice Address - Phone:216-785-0693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide