Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 25MM000002900 | NJ |
N | 176B00000X | Midwife | F001936-01 | NY |
NPI | 1174081848 |
---|---|
Provider Name | Elisa Juliett Weatherbee |
First Address | Hamilton, NJ 08619-4325 |
Second Address | Hamilton, NJ 08619-4325 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2019 |
Last Update Date | 23/04/2021 |