Minninger, Vicky Dianne

Minninger, Vicky Dianne is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Minninger, Vicky Dianne can be contacted via phone (601) 984-6525.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-6525
Fax: (601) 984-6764
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R638633 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R638633 Mississippi

Profile Details

NPI number 1346297090
LBN Legal business name Minninger, Vicky Dianne
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 28th, 2006
Last updated Aug 10th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346297090 NPPES
Mississippi Other 500005456 RAILROAD
Mississippi MEDICAID 0118842 RAILROAD
Mississippi MEDICAID 105774 RAILROAD
Mississippi Other 512G700003 RAILROAD

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