Provider Demographics
NPI:1871986901
Name:MINCIUNA, ANCA
Entity type:Individual
Prefix:
First Name:ANCA
Middle Name:
Last Name:MINCIUNA
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 1:30677 MAYVILLE ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3370
Mailing Address - Country:US
Mailing Address - Phone:734-788-4356
Mailing Address - Fax:
Practice Address - Street 1:30677 MAYVILLE ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3370
Practice Address - Country:US
Practice Address - Phone:734-788-4356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-13
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704241196163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse