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General NPI Number Information
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NPI Number | 1659871572
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Entity Type | Individual
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Provider Name | NICOLE M MYERS CNM
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Gender | Female
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Dates
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Enumeration Date | 02/16/2018
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 2 TREE FARM ROAD SUITE A110
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City | PENNINGTON
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State | NJ
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Zip | 08534
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Country | US
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Telephone | 609-737-7512
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Fax | 609-737-0978
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Provider Business Mailing Address
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Address Line | 2734 MONMOUTH RD
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City | JOBSTOWN
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State | NJ
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Zip | 08041
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Country | US
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Telephone | 609-668-4146
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Fax | 609-737-0978
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR17989500
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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 | 25ME00064000
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License Number State | NJ
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