Provider Demographics
NPI:1255626396
Name:HEMINK, JO ELLEN (RPH)
Entity type:Individual
Prefix:MRS
First Name:JO
Middle Name:ELLEN
Last Name:HEMINK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 BLOOMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3073
Mailing Address - Country:US
Mailing Address - Phone:612-871-1989
Mailing Address - Fax:
Practice Address - Street 1:2020 BLOOMINGTON AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3073
Practice Address - Country:US
Practice Address - Phone:612-871-1989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
MN117392183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No171400000XOther Service ProvidersHealth & Wellness Coach