Healthcare Provider Details

I. General information

NPI: 1992977086
Provider Name (Legal Business Name): DAPHNE ALAYNE MCINTOSH C.P.M., L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2008
Last Update Date: 03/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 SHADYCREST LN
FRANKLIN TN
37064-5110
US

IV. Provider business mailing address

2728 BROWN HOLLOW RD
COLUMBIA TN
38401-7179
US

V. Phone/Fax

Practice location:
  • Phone: 615-791-6645
  • Fax:
Mailing address:
  • Phone: 615-948-6294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number42
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: