Provider Demographics
NPI:1366412298
Name:ZIEGENFUS-MARTIN, JANE LOUISE (CNM)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:LOUISE
Last Name:ZIEGENFUS-MARTIN
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 1:639 OAKWOOD LANE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-2465
Mailing Address - Country:US
Mailing Address - Phone:717-291-6675
Mailing Address - Fax:717-291-6675
Practice Address - Street 1:639 OAKWOOD LANE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2465
Practice Address - Country:US
Practice Address - Phone:717-291-6675
Practice Address - Fax:717-291-6675
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW008134L176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001420734Medicaid
PA437646ESCMedicare ID - Type Unspecified
PA001420734Medicaid