MEDICARE: JENNIFER FATIMAH MOORE DOULA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula		OH

General Provider Information

NPI Number	:	1033065107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER FATIMAH MOORE DOULA

Provider Business Mailing Address
First Line	:	1239 BELLFLOWER AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-2229
Country	:	US
Telephone Number	:	380-210-9958
Fax Number	:

Provider Business Practice Location Address
First Line	:	1239 BELLFLOWER AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-2229
Country	:	US
Telephone Number	:	380-210-9958
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/12/2026

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