MEDICARE: MRS. TAMMY A. MOTZENBECKER C.N.M

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	25ME00049101	NJ

General Provider Information

NPI Number	:	1699070300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAMMY A. MOTZENBECKER C.N.M

Provider Business Mailing Address
First Line	:	301 LIPPINCOTT DR STE 410
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-4197
Country	:	US
Telephone Number	:	856-355-0340
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 INDEPENDENCE BLVD STE 100
Second Line	:
City	:	SICKLERVILLE
State	:	NJ
Zip	:	08081-1039
Country	:	US
Telephone Number	:	856-341-8474
Fax Number	:	856-325-5003

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2011
Last Update Date	:	08/09/2024

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