Healthcare Provider Details

I. General information

NPI: 1629782818
Provider Name (Legal Business Name): AGAPE MIDWIFERY AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2322 N INTERSTATE DR STE 2
NORMAN OK
73072-2942
US

IV. Provider business mailing address

1608 NORTHCREST DR
NORMAN OK
73071-7415
US

V. Phone/Fax

Practice location:
  • Phone: 405-819-4904
  • Fax: 405-896-8741
Mailing address:
  • Phone: 405-819-4904
  • Fax: 405-896-8741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE MARIE LUGRAND
Title or Position: OWNER
Credential: CLC, LCCE, ADVCD/PCD
Phone: 405-819-4904