Provider Demographics
NPI:1346127388
Name:CHAVEZ, EMILY MARIE (CNM)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 BURNS AVE
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-1201
Mailing Address - Country:US
Mailing Address - Phone:551-795-6764
Mailing Address - Fax:
Practice Address - Street 1:609 WASHINGTON ST FL 2
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-4907
Practice Address - Country:US
Practice Address - Phone:201-659-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00091201367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife