Individual
ELLEN J WORMSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM LNM
Contact information
Practice address
374 GRAND AVENUE, FAIR HAVEN COMMUNITY HEALTH CTR, NEW HAVEN, CT 06513
(203) 777-7411
(203) 777-8506
Mailing address
85 BEDFORD AVENUE, HAMDEN, CT 06517
(203) 281-1345
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
—
—
367A00000X
Advanced Practice Midwife
000054
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000549734
CT CARE
—
01
—
183840
PREFERRED ONE
—
01
—
400000054CT01
ANTHEM BCBS
—
01
—
P523092
OXFORD
—
Enumeration date
10/02/2006
Last updated
01/20/2023
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