Provider Demographics
NPI:1366322968
Name:MINOR, TONYA YVONNNE
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:YVONNNE
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 1:107 GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:MEADOW BRIDGE
Mailing Address - State:WV
Mailing Address - Zip Code:25976-9800
Mailing Address - Country:US
Mailing Address - Phone:304-222-5636
Mailing Address - Fax:304-222-5636
Practice Address - Street 1:107 GROVE AVE
Practice Address - Street 2:
Practice Address - City:MEADOW BRIDGE
Practice Address - State:WV
Practice Address - Zip Code:25976-9800
Practice Address - Country:US
Practice Address - Phone:304-222-5636
Practice Address - Fax:304-222-5636
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant