Provider Demographics
NPI:1073660429
Name:MECHLIN, JOAN RUTH (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:RUTH
Last Name:MECHLIN
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:208 E GORGAS LN
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-1929
Mailing Address - Country:US
Mailing Address - Phone:215-849-2986
Mailing Address - Fax:215-849-8756
Practice Address - Street 1:795 WOODLANE RD STE 301
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-3832
Practice Address - Country:US
Practice Address - Phone:609-267-1377
Practice Address - Fax:609-265-9286
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00105100363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner