Healthcare Provider Details

I. General information

NPI: 1336894567
Provider Name (Legal Business Name): EMILY LISBETH HURSH CD(DONA)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMILY LISBETH WINTERS

II. Dates (important events)

Enumeration Date: 02/16/2022
Last Update Date: 02/16/2022
Certification Date: 02/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 OCEAN PKWY APT 2C
BROOKLYN NY
11218-2531
US

IV. Provider business mailing address

130 OCEAN PKWY APT 2C
BROOKLYN NY
11218-2531
US

V. Phone/Fax

Practice location:
  • Phone: 419-543-1790
  • Fax:
Mailing address:
  • Phone: 419-543-1790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: