Healthcare Provider Details
I. General information
NPI: 1639209505
Provider Name (Legal Business Name): DAWN C DURAIN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
437 E STATE ST
TRENTON NJ
08608-1501
US
IV. Provider business mailing address
192 HOPEWELL PENNINGTON RD
HOPEWELL NJ
08525-2129
US
V. Phone/Fax
- Phone: 609-599-4881
- Fax:
- Phone: 609-466-0802
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | 25ME00011101 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: