Averill Moffitt, Jennifer J

Averill Moffitt, Jennifer J is an individual health care provider with primary practice located at 26 Queen St Family Health Center Of Worcester, Inc., Worcester MA 01610-2473. She recently has only one registered license in Other Service Providers / Midwife, which is considered as her primary health care specialty. Averill Moffitt, Jennifer J can be contacted via phone (508) 860-7700.

Contact Information

Primary practice address
26 Queen St Family Health Center Of Worcester, Inc. Worcester MA 01610-2473
Phone: (508) 860-7700
Fax: (508) 860-7929
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Midwife 176B00000X 257370 Massachusetts

Profile Details

NPI number 1730145533
LBN Legal business name Averill Moffitt, Jennifer J
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2006
Last updated Sep 2nd, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730145533 NPPES
Massachusetts MEDICAID 1300709
Massachusetts Other Y10141
Massachusetts Other CN0334

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