Individual
MS. MINDY SUSAN HAENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3 COOPER PLZ, SUITE 411, CAMDEN, NJ 08103-1438
(856) 342-3113
(856) 968-8388
Mailing address
3 COOPER PLZ, SUITE 403, CAMDEN, NJ 08103-1438
(856) 342-3113
(856) 541-5379
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
C5-0000363
DE
363AS0400X
Surgical Physician Assistant
Primary
25MP00161700
NJ
363AS0400X
Surgical Physician Assistant
C5-0000363
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001001202
—
DE
01
—
2120316000
AMERIHEALTH
—
01
—
2935112
AETNA
—
01
—
Q41476
BLUE SHIELD OF DE
—
Enumeration date
02/27/2006
Last updated
01/10/2011
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