Provider Demographics
NPI:1700633161
Name:MINIX, REMONICA (APRN)
Entity type:Individual
Prefix:
First Name:REMONICA
Middle Name:
Last Name:MINIX
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 ROY CAMPBELL DR STE B
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9485
Mailing Address - Country:US
Mailing Address - Phone:606-439-0051
Mailing Address - Fax:
Practice Address - Street 1:243 ROY CAMPBELL DR STE B
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9485
Practice Address - Country:US
Practice Address - Phone:606-439-0051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-03
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4019228363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner