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General NPI Number Information
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NPI Number | 1356643134
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Entity Type | Organization
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Legal Business Name | HACKETTSTOWN MIDWIVES
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Dates
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Enumeration Date | 11/29/2010
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Last Update Date | 07/23/2014
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Provider Practice Location Address
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Address Line | 57 US HIGHWAY 46 STE 300
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City | HACKETTSTOWN
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State | NJ
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Zip | 07840-2695
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Country | US
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Telephone | 908-509-1801
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Fax | 732-301-9252
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Provider Business Mailing Address
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Address Line | PO BOX 253
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City | BUDD LAKE
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State | NJ
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Zip | 07828-0253
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Country | US
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Telephone | 908-509-1801
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Fax | 732-301-9252
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | LISA ANN LEDERER
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Credential | CNM
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Telephone | 908-399-5059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ00501100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 25ME00035501
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License Number State | NJ
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