Healthcare Provider Details

I. General information

NPI: 1972399657
Provider Name (Legal Business Name): HEATHER ELISE LOVELESS CNM, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ENGLISH CREEK AVE BLDG 1000, STE 1000
EGG HARBOR TOWNSHIP NJ
08234
US

IV. Provider business mailing address

2500 ENGLISH CREEK AVE BLDG 1000, STE 1000
EGG HARBOR TOWNSHIP NJ
08234
US

V. Phone/Fax

Practice location:
  • Phone: 609-677-7211
  • Fax: 609-677-7210
Mailing address:
  • Phone: 609-677-7211
  • Fax: 609-677-7210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP032548
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberMW010858
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number25ME00090500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: