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Individual

MICHELLE MINOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
612 WILBUR AVE, HAMMONTON, NJ 08037-1359
(609) 214-4891
Mailing address
612 WILBUR AVE, HAMMONTON, NJ 08037-1359
(609) 214-4891

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR15458700
NJ
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00581200
NJ

Other

Enumeration date
03/26/2015
Last updated
08/04/2016
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