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General NPI Number Information
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NPI Number | 1073852273
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Entity Type | Individual
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Provider Name | EMILY JOY MINES APN
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Gender | Female
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Dates
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Enumeration Date | 02/07/2013
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Last Update Date | 04/11/2014
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Provider Practice Location Address
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Address Line | 101 SPRINGDALE ROAD HOLLY RAVINE PLAZA, MINUTECLINIC
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City | CHERRY HILL
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State | NJ
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Zip | 08003-3833
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Country | US
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Telephone | 856-428-5909
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Fax |
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Provider Business Mailing Address
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Address Line | 28 PEROT AVE
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City | CHERRY HILL
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State | NJ
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Zip | 08003-3833
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Country | US
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Telephone | 609-221-7584
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00420700
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License Number State | NJ
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