Individual
KASEY C DIVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
408 MAIN ST STE 401A, BOONTON, NJ 07005-1732
(201) 230-4464
(866) 715-8797
Mailing address
307 3RD ST, BELVIDERE, NJ 07823-1832
(201) 230-4464
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
25ME00075701
NJ
176B00000X
Midwife
25MW00001700
NJ
Other
Enumeration date
07/13/2012
Last updated
05/10/2022
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