Provider Demographics
NPI:1538966379
Name:MINOR, MADELINE MICHELLE (NP)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:MICHELLE
Last Name:MINOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5400 BEAUMONT DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-9709
Mailing Address - Country:US
Mailing Address - Phone:214-673-6458
Mailing Address - Fax:
Practice Address - Street 1:4709 CREEKSTONE DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-9822
Practice Address - Country:US
Practice Address - Phone:919-385-8880
Practice Address - Fax:919-862-5782
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC5021744363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics