Healthcare Provider Details

I. General information

NPI: 1326924507
Provider Name (Legal Business Name): EMBRACE CHILDBIRTH & LACTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

764 KYNDAL CT
GARDNERVILLE NV
89460-7570
US

IV. Provider business mailing address

764 KYNDAL CT
GARDNERVILLE NV
89460-7570
US

V. Phone/Fax

Practice location:
  • Phone: 530-414-1348
  • Fax:
Mailing address:
  • Phone: 530-414-1348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KRYSTAL M LONG
Title or Position: CEO
Credential: CLC
Phone: 530-414-1348