Individual provider · NPI-1

Mindy Susan Haenn, PA-C

Physician Assistant, Surgical · Camden, NJ

NPI number1740256965

StatusActive

Last updated in NPPESJan 10, 2011

Details

NPI: 1740256965
Entity type: Individual (NPI-1)
Name: Ms. Mindy Susan Haenn
Credential: PA-C
Sex: Female
Sole proprietor: No
Enumeration date: Feb 27, 2006
Last updated: Jan 10, 2011

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363AS0400X	Physician Assistant, Surgical	25MP00161700	NJ	Yes
363AS0400X	Physician Assistant, Surgical	C5-0000363	DE
207T00000X	Neurological Surgery	C5-0000363	DE

Practice location

3 Cooper Plz
Suite 411
Camden, NJ 08103-1438

Phone 856-342-3113 · Fax 856-968-8388

Mailing address

3 Cooper Plz
Suite 403
Camden, NJ 08103-1438

Phone 856-342-3113 · Fax 856-541-5379

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.