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NPI Code Detail

MEDICARE: AMBER JOY KAY CD(DONA), LCCE

MEDICARE: AMBER JOY KAY CD(DONA), LCCE
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
1374J00000XDoula

General Provider Information

NPI Number : 1548539448
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER JOY KAY CD(DONA), LCCE
Provider Business Mailing Address
First Line : 3848 NICOLLET AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55409-1304
Country : US
Telephone Number : 612-636-3953
Fax Number :
Provider Business Practice Location Address
First Line : 3848 NICOLLET AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55409-1304
Country : US
Telephone Number : 612-636-3953
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2011
Last Update Date : 12/21/2011

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