Healthcare Provider Details

I. General information

NPI: 1154261097
Provider Name (Legal Business Name): NATALIE C WATSON DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 N 73RD ST
CAHOKIA HEIGHTS IL
62203-2606
US

IV. Provider business mailing address

PO BOX 23294
BELLEVILLE IL
62223-0294
US

V. Phone/Fax

Practice location:
  • Phone: 618-815-7612
  • Fax:
Mailing address:
  • Phone: 618-815-7612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: