Healthcare Provider Details

I. General information

NPI: 1700155660
Provider Name (Legal Business Name): JESSICA A FUSS CD(DONA)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2011
Last Update Date: 12/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 HIGHVIEW DR
WEST WARWICK RI
02893-3126
US

IV. Provider business mailing address

78 HIGHVIEW DR
WEST WARWICK RI
02893-3126
US

V. Phone/Fax

Practice location:
  • Phone: 401-837-0922
  • Fax:
Mailing address:
  • Phone: 401-837-0922
  • 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: