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NPI Code Detail

MEDICARE: SHIRLEY MCDUFFIE CNM

MEDICARE: SHIRLEY MCDUFFIE CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse26NO06323700NJ
2367A00000XAdvanced Practice Midwife25ME00023001NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11932370483OTHERNJ101 LUDLOW
21740345693OTHERNJ741 BROADWAY
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
41194996645OTHERNJ444 WILLIAM ST
51548431091OTHERNJ982 BROAD ST
61619148160OTHERNJ516 BERGEN ST
71235300799OTHERNJ37 N DAY
81972778413OTHERNJ1150 SPRINGFIELD
91063683258OTHERNJ751 BROADWAY

General Provider Information

NPI Number : 1083656888
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIRLEY MCDUFFIE CNM
Provider Business Mailing Address
First Line : 741 BROADWAY
Second Line :
City : NEWARK
State : NJ
Zip : 07104-4309
Country : US
Telephone Number : 973-483-1300
Fax Number :
Provider Business Practice Location Address
First Line : 741 BROADWAY
Second Line :
City : NEWARK
State : NJ
Zip : 07104-4309
Country : US
Telephone Number : 973-483-1300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2006
Last Update Date : 06/05/2008

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Directions to “ SHIRLEY MCDUFFIE CNM” Practice Location

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