Healthcare Provider Details

I. General information

NPI: 1902661465
Provider Name (Legal Business Name): AMY COLLEEN STONER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 FRANKLIN CORNER RD STE 214
LAWRENCEVILLE NJ
08648-2526
US

IV. Provider business mailing address

430 PINE ST
ROYERSFORD PA
19468-1928
US

V. Phone/Fax

Practice location:
  • Phone: 609-537-7200
  • Fax:
Mailing address:
  • Phone: 602-820-0959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number25ME00085500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: