Individual
JOHN JINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
118 UNION ST, WOOD RIDGE, NJ 07075-2415
(615) 517-0920
Mailing address
118 UNION ST, WOOD RIDGE, NJ 07075-2415
(615) 517-0920
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NR19204700
NJ
Other
Enumeration date
09/10/2020
Last updated
09/10/2020
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