Healthcare Provider Details

I. General information

NPI: 1194426965
Provider Name (Legal Business Name): ABIGAIL ANN WINCHESTER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2023
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
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

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

V. Phone/Fax

Practice location:
  • Phone: 732-994-4242
  • Fax: 732-363-5164
Mailing address:
  • Phone: 732-994-4242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number25ME00091700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: