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General NPI Number Information
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NPI Number | 1326665845
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Entity Type | Individual
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Provider Name | JENNIFER ANN WIENGES CPM
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Gender | Female
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Dates
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Enumeration Date | 06/30/2020
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Last Update Date | 06/30/2020
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Provider Practice Location Address
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Address Line | 1052 COMMERCIAL ST
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City | ROCKPORT
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State | ME
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Zip | 04856-3801
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Country | US
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Telephone | 706-206-9909
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1301
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City | ROCKPORT
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State | ME
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Zip | 04856-1301
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Country | US
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Telephone | 706-206-9909
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Fax | 207-358-2558
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | CPM682
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License Number State | ME
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