Provider Demographics
NPI:1538432323
Name:LEVI, MIRIAM E (FNP-BC, WHNP-BC, CNM)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:E
Last Name:LEVI
Suffix:
Gender:F
Credentials:FNP-BC, WHNP-BC, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4432 OAK CT SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-8869
Mailing Address - Country:US
Mailing Address - Phone:917-572-9719
Mailing Address - Fax:
Practice Address - Street 1:34 MAPLE ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3815
Practice Address - Country:US
Practice Address - Phone:203-852-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2025-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR15139600163WW0101X
NY629822-1163WW0101X
PAMW010310176B00000X
NYF001479176B00000X
WAAP60664597363LF0000X
PASP014753363LF0000X
WAAP60295389367A00000X
MN431367A00000X
CT371367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No176B00000XOther Service ProvidersMidwife
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily