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Contact Information

LESLEY A GUSTAFSON, CNM
140 GRANDVIEW AVE
SUITE 202
WATERBURY, CT06708
 Phone: 203-755-2344
 Fax: 203-573-8166
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Advanced Practice Midwife

367A00000X 42 Certified Nurse Midwife
Indicates primary specialty

NPI Profile & details for LESLEY A GUSTAFSON · (Female)

NPI Number 1639163199
Status Active
Credentials CNM (Certified Nurse Midwife)
Entity Individual
Enumeration date 09/09/2005
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 No
Identifiers
  • WV License # 114
  • WV License # 57006
  • WV Medicaid 9450001000
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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