Provider Demographics
NPI:1871525212
Name:MINTON, JULIA ANN (CRNA)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ANN
Last Name:MINTON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CARVINE CT
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7662
Mailing Address - Country:US
Mailing Address - Phone:412-638-3410
Mailing Address - Fax:
Practice Address - Street 1:500 CARVINE CT
Practice Address - Street 2:#107
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7662
Practice Address - Country:US
Practice Address - Phone:412-638-3410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN252208L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
054768OtherAANA NO.
OH2411741Medicaid
054768OtherAANA NO.