Provider Demographics
NPI:1497429807
Name:CAIN, GINA (APN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:CAIN
Suffix:
Gender:F
Credentials:APN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ALLEN ST STE 2D
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-7652
Mailing Address - Country:US
Mailing Address - Phone:732-703-6956
Mailing Address - Fax:732-606-4145
Practice Address - Street 1:10 ALLEN ST STE 2D
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7652
Practice Address - Country:US
Practice Address - Phone:732-703-6956
Practice Address - Fax:732-606-4145
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01168600363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health