Provider Demographics
NPI:1558117432
Name:ROSETTI, MIRIAM ANNA (CNM, WHNP)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:ANNA
Last Name:ROSETTI
Suffix:
Gender:F
Credentials:CNM, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:798 CENTERTON RD
Mailing Address - Street 2:
Mailing Address - City:ELMER
Mailing Address - State:NJ
Mailing Address - Zip Code:08318-3945
Mailing Address - Country:US
Mailing Address - Phone:856-358-1100
Mailing Address - Fax:
Practice Address - Street 1:798 CENTERTON RD
Practice Address - Street 2:
Practice Address - City:ELMER
Practice Address - State:NJ
Practice Address - Zip Code:08318-3945
Practice Address - Country:US
Practice Address - Phone:856-358-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00086301367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife