Healthcare Provider Details

I. General information

NPI: 1124897988
Provider Name (Legal Business Name): LUZEBERTE ST HUBERT DNP, WHNP-BC, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2023
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
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

285 WHITON ST
JERSEY CITY NJ
07304-4178
US

V. Phone/Fax

Practice location:
  • Phone: 609-537-7200
  • Fax:
Mailing address:
  • Phone: 201-744-1848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number26NJ15025200
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number25ME00085001
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: