Healthcare Provider Details

I. General information

NPI: 1871961425
Provider Name (Legal Business Name): JENNIFER E SANTOS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2015
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1382 LANES MILL RD STE 201
LAKEWOOD NJ
08701-3894
US

IV. Provider business mailing address

1100 WESCOTT DRIVE STE 105
FLEMINGTON NJ
08822
US

V. Phone/Fax

Practice location:
  • Phone: 732-994-4242
  • Fax: 732-363-5164
Mailing address:
  • Phone: 908-788-6469
  • Fax: 908-788-6483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number25ME00057801
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: