Healthcare Provider Details

I. General information

NPI: 1629287818
Provider Name (Legal Business Name): CHRISTIE ILENE WERYNSKI CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 01/13/2020
Certification Date: 01/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W. WALNUT STREET, STE. 925E CURTIS CENTER INDEPENDENCE SQUARE WEST
PHILADELPHIA PA
19106-3304
US

IV. Provider business mailing address

601 W. WALNUT STREET, STE. 925E CURTIS CENTER INDEPENDENCE SQUARE WEST
PHILADELPHIA PA
19106-3304
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-8000
  • Fax: 215-829-3701
Mailing address:
  • Phone: 215-829-8000
  • Fax: 215-829-3701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number26NR09587000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberMW010135
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: