Healthcare Provider Details
I. General information
NPI: 1205863875
Provider Name (Legal Business Name): LORI A. SHERMAN MPH, MSN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 PROSPECT ST SUITE 202
LAKEWOOD NJ
08701-5020
US
IV. Provider business mailing address
528 S MELVILLE ST
PHILADELPHIA PA
19143-2110
US
V. Phone/Fax
- Phone: 732-942-4442
- Fax:
- Phone: 215-662-0749
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | ME00039301 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: