Provider Demographics
NPI:1750696043
Name:SUTHERLAND, ESSENCE T (CNM, APRN)
Entity type:Individual
Prefix:
First Name:ESSENCE
Middle Name:T
Last Name:SUTHERLAND
Suffix:
Gender:F
Credentials:CNM, APRN
Other - Prefix:
Other - First Name:ESSENCE
Other - Middle Name:T
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM, APRN
Mailing Address - Street 1:1601 HADDON AVE
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-3109
Mailing Address - Country:US
Mailing Address - Phone:856-549-8100
Mailing Address - Fax:
Practice Address - Street 1:1601 HADDON AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-3109
Practice Address - Country:US
Practice Address - Phone:856-549-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN615066163W00000X
NJ25ME00085600176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse