Healthcare Provider Details

I. General information

NPI: 1922949734
Provider Name (Legal Business Name): BIRTH MOTHER LOVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

200 HUB ST
JEFFERSON CITY MO
65109-4619
US

IV. Provider business mailing address

200 HUB ST
JEFFERSON CITY MO
65109-4619
US

V. Phone/Fax

Practice location:
  • Phone: 573-680-4000
  • Fax:
Mailing address:
  • Phone: 573-680-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MICHELLE M LOVE
Title or Position: DOULA
Credential:
Phone: 573-680-4000