Tanya E Minkevich De Visser, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

044737 Issued in MO

Practice address

4023 S Noland Rd
Independence, MO 64055-6507

Phone

(816) 254-1366

NPI assigned

Aug 20, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Miss Tanya Elizabeth Minkevich Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461456000000",
    "number": "1497902548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4746 FAIRMOUNT AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641121113",
            "telephone_number": "816-213-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4023 S NOLAND RD",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556507",
            "telephone_number": "816-254-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VISSER",
        "first_name": "TANYA",
        "middle_name": "E MINKEVICH",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-20",
        "last_updated": "2016-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "044737",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-12737",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANYA",
            "last_name": "MINKEVICH",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "RPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicholas Davis, DPT
• Regina Marie Davis, CRNA, APN, MSN
• Sarah Davis
• Amelia Dawdy
• Brett T Dawson, OD
• Amber Dealy, PLPC
• Kenneth Martin Deblock, LPC
• Whitney Decker, APRN
• Dedicated Missouri Holding, LLC
• Marsha Lee Dedrick, SLP

• Pharmacist in Independence, MO
• Providers in Independence, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.