Provider Demographics
NPI:1417207598
Name:CEREMY, JOELLE (CNM)
Entity type:Individual
Prefix:
First Name:JOELLE
Middle Name:
Last Name:CEREMY
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 1:11421 CANE CROSSING RD
Mailing Address - Street 2:APT. # 1116
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-4234
Mailing Address - Country:US
Mailing Address - Phone:786-290-6069
Mailing Address - Fax:
Practice Address - Street 1:737 CHAUCER CIR
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-6591
Practice Address - Country:US
Practice Address - Phone:704-942-8723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN.28522176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife