Provider Demographics
NPI:1639446495
Name:PEREZ, JASMINE (CNM, CD(DONA), IBCLC)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:CNM, CD(DONA), IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 E SPENCER LN
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-3256
Mailing Address - Country:US
Mailing Address - Phone:917-569-6564
Mailing Address - Fax:
Practice Address - Street 1:302 E SPENCER LN
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-3256
Practice Address - Country:US
Practice Address - Phone:917-569-6564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ374J00000X
NJ25ME00050100367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife