MS. MINDY SUSAN HAENN (NPI# 1740256965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740256965 |
| Entity Type | Individual |
| Full Name | MS. MINDY SUSAN HAENN |
| Credential | PA-C |
| Practice Address |
3 Cooper Plz Suite 411 Camden NJ 08103-1438 |
| Mailing Address |
3 Cooper Plz Suite 403 Camden NJ 08103-1438 |
| Practice Telephone | 8563423113 |
| Practice Fax Number | 8569688388 |
| Mailing Telephone | 8563423113 |
| Mailing Fax Number | 8565415379 |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2011-01-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207T00000X | Neurological Surgery | C5-0000363 | DE | Allopathic & Osteopathic Physicians |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
25MP00161700 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
C5-0000363 | DE | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AETNA | 2935112 | 01 | |
| BLUE SHIELD OF DE | Q41476 | 01 | |
| BLUE SHIELD PC | 2120316000 | 01 | |
| KEYSTONE | 2120316000 | 01 | |
| AMERIHEALTH | 2120316000 | 01 | |
| DE | 0001001202 | 05 |
| Street Address |
3 COOPER PLZ SUITE 411 |
| City | CAMDEN |
| State | NJ |
| Zip Code | 08103-1438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164427241 | Christopher T Olivia | Ophthalmology | 3 Cooper Plz, Rm 510, Camden, NJ 08103-1438 | 2005-06-16 |
| 1932718897 | Yaritza Santana-orozco | Student in an Organized Health Care Education/Training Program | 3 Cooper Plz, Camden, NJ 08103-1438 | 2020-07-27 |
| 1053929588 | Karl Leon Snyder | Counselor | 3 Cooper Plz, Camden, NJ 08103-1438 | 2020-07-21 |
| 1861000606 | Jordan Murphy | Community Health Worker | 3 Cooper Plz, Camden, NJ 08103-1438 | 2020-07-17 |
| 1740808823 | Alexandria Davenport | Physician Assistant | 3 Cooper Plz, Camden, NJ 08103-1438 | 2020-07-06 |
| 1457978629 | Osama M Sayed | Student in an Organized Health Care Education/Training Program | 3 Cooper Plz, Camden, NJ 08103-1438 | 2020-07-02 |
| 1952948234 | Christy Lambert | Physical Therapist | 3 Cooper Plz, Camden, NJ 08103-1438 | 2019-12-05 |
| 1598301368 | Yamna Azhar | Pharmacist | 3 Cooper Plz, Camden, NJ 08103-1438 | 2019-11-26 |
| 1588215792 | Adisa Kljuco | Nurse Practitioner | 3 Cooper Plz, Camden, NJ 08103-1438 | 2019-09-28 |
| 1083272470 | Jasmine Marahar | Student in an Organized Health Care Education/Training Program | 3 Cooper Plz, Camden, NJ 08103-1438 | 2019-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912516063 | Toni Marie Primas | Registered Nurse | Sheridan Pavilion, Three Cooper Plaza Suite 220, Camden, NJ 08103 | 2020-07-24 |
| 1376028548 | Services To Overcome Drug Abuse Among Teenagers, Inc. | Clinic/Center | 805-815 Federal Street, Camden, NJ 08103 | 2018-10-03 |
| 1942795802 | Kyle Richard Marden | Student in an Organized Health Care Education/Training Program | 401 Haddon Avenue, 2nd Floor Room 266, Camden, NJ 08103 | 2018-06-24 |
| 1588157473 | Julio Antonio Rodriguez Jr. | Student in an Organized Health Care Education/Training Program | Cooper University Hospital, 3 Cooper Plaza Suite 408, Camden, NJ 08103 | 2018-06-14 |
| 1386149748 | Shuchi Gupta | Nurse Practitioner | 519 West Street, Camden, NJ 08103 | 2018-03-28 |
| 1326541491 | Bolanle Idowu-akangbe | Nurse Practitioner | 519-525 West Street, Camden, NJ 08103 | 2018-03-14 |
| 1740709500 | New Beginnings Behavioral Health | Clinic/Center | 1300 Princess Avenue, Camden, NJ 08103 | 2017-09-13 |
| 1760905012 | Loraine Morris | Counselor | 1479 Kaighn Ave, Camden, NJ 08103 | 2017-07-19 |
| 1386164333 | Matthew Share | Genetic Counselor, MS | Two Cooper Plaza, 400 Haddon Avenue, Md Anderson Cancer Center, Camden, NJ 08103 | 2017-06-21 |
| 1568902070 | Cooper University Hospital | General Acute Care Hospital | 1 Cooper Plaza, Dorrance 222, Camden, NJ 08103 | 2017-03-02 |
| Find all providers in zip 08103 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740808823 | Alexandria Davenport | Physician Assistant | 3 Cooper Plz, Camden, NJ 08103-1438 | 2020-07-06 |
| 1700428075 | Stephanie Lynne Benko | Physician Assistant | 3 Cooper Plz Rm 411, Camden, NJ 08103-1438 | 2019-10-08 |
| 1699326389 | Nicole Marie Miehle | Physician Assistant | 1 Cooper Plz, Camden, NJ 08103 | 2019-09-24 |
| 1851842082 | Danielle Warfel | Physician Assistant | 3 Cooper Plz, Camden, NJ 08103 | 2016-10-24 |
| 1619328564 | Stanislav Borodyansky | Physician Assistant | 3 Cooper Plz Rm 408, Camden, NJ 08103 | 2016-06-22 |
| 1114341724 | Evelyn Ulzheimer | Physician Assistant | 1 Cooper Plz, Camden, NJ 08103-1461 | 2014-02-18 |
| 1326336603 | Megan Clark | Physician Assistant | 3 Cooper Plz, Suite 411, Camden, NJ 08103-1438 | 2011-07-20 |
| 1275865198 | Jamie Mora | Physician Assistant | 1 Cooper Plz, Camden, NJ 08103 | 2010-02-02 |
| 1740465962 | Rachel Waldman | Physician Assistant | 1 Cooper Plz, Camden, NJ 08103-1461 | 2008-01-07 |
| 1063576825 | Robert W. Young | Physician Assistant | 3 Cooper Plz, Suite 403, Camden, NJ 08103-1438 | 2006-12-19 |
| Find all providers in CAMDEN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.