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NPI Code Detail

MEDICARE: MS. ALETA JOY CNM

MEDICARE: MS. ALETA JOY 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
1367A00000XAdvanced Practice MidwifeCNM172003ME

General Provider Information

NPI Number : 1720503527
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ALETA JOY CNM
Provider Business Mailing Address
First Line : 12 HIGH ST STE 200
Second Line :
City : LEWISTON
State : ME
Zip : 04240-7689
Country : US
Telephone Number : 207-795-5770
Fax Number : 207-795-5779
Provider Business Practice Location Address
First Line : 12 HIGH ST STE 200
Second Line :
City : LEWISTON
State : ME
Zip : 04240-7689
Country : US
Telephone Number : 207-795-5770
Fax Number : 207-795-5779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2017
Last Update Date : 05/01/2018

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