Healthcare Provider Details

I. General information

NPI: 1437668407
Provider Name (Legal Business Name): JESSICA LYNN JACKSON LOVE DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA LOVE DOULA

II. Dates (important events)

Enumeration Date: 09/21/2017
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3046 MELKRIDGE ST
COLUMBUS OH
43219-7371
US

IV. Provider business mailing address

3046 MELKRIDGE ST
COLUMBUS OH
43219-7371
US

V. Phone/Fax

Practice location:
  • Phone: 740-497-8803
  • Fax:
Mailing address:
  • Phone: 740-497-8803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License NumberDOU000066
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: