Basic Information
| Provider Information | |||||||||
| NPI: | 1235419516 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | JODI WINEMILLER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 875 ORANGE ST | ||||||||
| Address2: | |||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192519202 | ||||||||
| FaxNumber: | 2037778506 | ||||||||
| Practice Location | |||||||||
| Address1: | 875 ORANGE ST | ||||||||
| Address2: | |||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192519202 | ||||||||
| FaxNumber: | 2037778506 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2011 | ||||||||
| LastUpdateDate: | 09/08/2011 | ||||||||
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| AuthorizedOfficialLastName: | WINEMILLER | ||||||||
| AuthorizedOfficialFirstName: | JODI | ||||||||
| AuthorizedOfficialMiddleName: | JEAN | ||||||||
| AuthorizedOfficialTitleorPosition: | CERTIFIED NURSE MIDWIFE | ||||||||
| AuthorizedOfficialTelephone: | 6192519202 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | MSN, CNM | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QB0400X | 000360 | CT | N | Ambulatory Health Care Facilities | Clinic/Center | Birthing | 261QF0050X | 000360 | CT | N | Ambulatory Health Care Facilities | Clinic/Center | Family Planning, Non-Surgical | 282N00000X | 000360 | CT | N | Hospitals | General Acute Care Hospital | 261QC1500X | 000360 | CT | Y | Ambulatory Health Care Facilities | Clinic/Center | Community Health |
No ID Information.