Provider Demographics
NPI:1073852273
Name:MINES, EMILY JOY (APN)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:JOY
Last Name:MINES
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 PEROT AVE
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3833
Mailing Address - Country:US
Mailing Address - Phone:609-221-7584
Mailing Address - Fax:
Practice Address - Street 1:101 SPRINGDALE ROAD
Practice Address - Street 2:HOLLY RAVINE PLAZA, MINUTECLINIC
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-3833
Practice Address - Country:US
Practice Address - Phone:856-428-5909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00420700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily