Provider Demographics
NPI:1811611668
Name:MINTEER, MATTHEW DONALD (MSN, APN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:DONALD
Last Name:MINTEER
Suffix:
Gender:M
Credentials:MSN, 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 1:650 RANCOCAS RD
Mailing Address - Street 2:
Mailing Address - City:WESTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-5613
Mailing Address - Country:US
Mailing Address - Phone:609-332-2119
Mailing Address - Fax:
Practice Address - Street 1:650 RANCOCAS RD
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-5613
Practice Address - Country:US
Practice Address - Phone:609-518-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01374000363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health