Healthcare Provider Details

I. General information

NPI: 1265940902
Provider Name (Legal Business Name): BRIGHT BLESSINGS BIRTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2018
Last Update Date: 01/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 KATHY DR
SHILOH IL
62269-3632
US

IV. Provider business mailing address

113 KATHY DR
SHILOH IL
62269-3632
US

V. Phone/Fax

Practice location:
  • Phone: 314-328-9662
  • Fax:
Mailing address:
  • Phone: 314-328-9662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: ANGELA M HILL
Title or Position: DIRECTOR
Credential: CD, CPPD, SBD, CBE
Phone: 314-328-9662