Provider Demographics
NPI:1639392020
Name:HEALEY, JOANNE (CNM)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:HEALEY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HAMILTON HEALTH PL
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3542
Mailing Address - Country:US
Mailing Address - Phone:609-631-6899
Mailing Address - Fax:
Practice Address - Street 1:1 HAMILTON HEALTH PL
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3542
Practice Address - Country:US
Practice Address - Phone:609-631-6899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00022501367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6138501Medicaid
NJ6138501Medicaid
NJ1120886Medicare ID - Type Unspecified