Individual
SHANNON LEIGH ANNE MIMNAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1100 WESCOTT DR STE 101, FLEMINGTON, NJ 08822-4600
(908) 788-6535
Mailing address
1100 WESCOTT DR STE 101, FLEMINGTON, NJ 08822-4600
(908) 788-6535
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB10958200
NJ
Other
Enumeration date
04/06/2018
Last updated
06/25/2021
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