Healthcare Provider Details

I. General information

NPI: 1669364576
Provider Name (Legal Business Name): NYASIA WHITE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 BELLEVUE AVE FL 3
TRENTON NJ
08618-4514
US

IV. Provider business mailing address

510 S 2ND ST
DARBY PA
19023-3105
US

V. Phone/Fax

Practice location:
  • Phone: 609-394-4111
  • Fax: 609-394-4070
Mailing address:
  • Phone: 215-909-3627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number25ME00092900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number25MM0004100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: