Healthcare Provider Details

I. General information

NPI: 1730995085
Provider Name (Legal Business Name): LABOR OF LOVE BIRTH & DOULA SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 NELSON LN
CLAYTON NC
27527-3980
US

IV. Provider business mailing address

212 NELSON LN
CLAYTON NC
27527-3980
US

V. Phone/Fax

Practice location:
  • Phone: 919-631-8095
  • Fax: 919-249-2157
Mailing address:
  • Phone: 919-631-8095
  • Fax: 919-249-2157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: WANDA HARVEY EVANS
Title or Position: SOLE PROPRIETOR
Credential: CD MA
Phone: 919-631-8095