Healthcare Provider Details

I. General information

NPI: 1568950897
Provider Name (Legal Business Name): MAEVE EBRIGHT CERTIFIED DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAEVE EBRIGHT CERTIFIED DOULA

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 S LEA AVE
ROSWELL NM
88203-4576
US

IV. Provider business mailing address

2306 MILLS DR
ROSWELL NM
88203-2408
US

V. Phone/Fax

Practice location:
  • Phone: 575-840-7615
  • Fax:
Mailing address:
  • Phone: 575-347-1315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: