Provider Demographics
NPI:1285764118
Name:WAYMAN, JEMINE L (CNM)
Entity type:Individual
Prefix:
First Name:JEMINE
Middle Name:L
Last Name:WAYMAN
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 1:675 S MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-3196
Mailing Address - Country:US
Mailing Address - Phone:203-250-2125
Mailing Address - Fax:203-271-3152
Practice Address - Street 1:136 SHERMAN AVE STE 502
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511
Practice Address - Country:US
Practice Address - Phone:203-562-5181
Practice Address - Fax:203-562-1053
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT407367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife