Healthcare Provider Details

I. General information

NPI: 1053651737
Provider Name (Legal Business Name): JENNIFER MARIE HALE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2013
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BOWMAN DR FL 3
VOORHEES NJ
08043-9612
US

IV. Provider business mailing address

611 W 18TH ST
WILMINGTON DE
19802-4707
US

V. Phone/Fax

Practice location:
  • Phone: 856-247-3000
  • Fax:
Mailing address:
  • Phone: 302-658-3331
  • Fax: 302-658-9306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLK-0000172
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number25ME00051801
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: