Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2007027755 | MO |
NPI | 1003002486 |
---|---|
Provider Name | Ms. Megan Kathleen Minner |
First Address | Washington, MO 63090-3303 |
Second Address | Washington, MO 63090-3303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2007 |
Last Update Date | 19/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1100652 | CIGNA PIN (01) | MO |
261152778MIN | MERCY PIN (01) | MO |
714177 | UNITED HEALTHCARE PIN (01) | MO |
9058107 | AETNA PIN (01) | MO |