Healthcare Provider Details

I. General information

NPI: 1144868498
Provider Name (Legal Business Name): LORAN MARIE BERNERT DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2019
Last Update Date: 10/09/2022
Certification Date: 10/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 BARRET AVE STE 301
LOUISVILLE KY
40204-1747
US

IV. Provider business mailing address

6615 MOROCCO DR
LOUISVILLE KY
40214-1122
US

V. Phone/Fax

Practice location:
  • Phone: 502-905-2300
  • Fax:
Mailing address:
  • Phone: 502-381-6618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: