Patricia Mary Connolly-Detura, R.N., C.N.M.

Primary specialty

MidwifeTaxonomy code 176B00000X

License

25ME00016101 Issued in NJ

Practice address

114 E Clinton Ave
Bergenfield, NJ 07621-3024

Phone

(201) 384-4955

Fax

(201) 384-2559

NPI assigned

Dec 24, 2008

Last updated

Sep 12, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Midwife, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1230076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1942446893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E CLINTON AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076213024",
            "telephone_number": "201-384-4955",
            "fax_number": "201-384-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E CLINTON AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076213024",
            "telephone_number": "201-384-4955",
            "fax_number": "201-384-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY-DETURA",
        "first_name": "PATRICIA",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "R.N., C.N.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-24",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR05601200",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "344654-1",
            "primary": false
        },
        {
            "code": "175L00000X",
            "taxonomy_group": "",
            "desc": "Homeopath",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NJ",
            "license": "25ME00016101",
            "primary": true
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NY",
            "license": "F000634-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Midwife in Bergenfield, NJ
• Providers in Bergenfield, NJ by specialty
• Midwife in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.