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General NPI Number Information
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NPI Number | 1750696043
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Entity Type | Individual
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Provider Name | ESSENCE T SUTHERLAND CNM, APRN
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Gender | Female
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Dates
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Enumeration Date | 08/11/2010
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 1601 HADDON AVE
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City | CAMDEN
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State | NJ
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Zip | 08103-3109
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Country | US
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Telephone | 856-549-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 HADDON AVE
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City | CAMDEN
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State | NJ
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Zip | 08103-3109
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Country | US
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Telephone | 856-549-8100
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Fax |
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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 | RN615066
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 25ME00085600
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License Number State | NJ
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