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General NPI Number Information
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NPI Number | 1578966115
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Entity Type | Organization
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Legal Business Name | BABY BUNDLE
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Dates
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Enumeration Date | 09/26/2014
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Last Update Date | 09/26/2014
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Provider Practice Location Address
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Address Line | 5152 POPLAR GROVE RD
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City | COOKEVILLE
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State | TN
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Zip | 38506-6805
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Country | US
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Telephone | 931-200-0463
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Fax |
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Provider Business Mailing Address
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Address Line | 5152 POPLAR GROVE RD
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City | COOKEVILLE
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State | TN
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Zip | 38506-6805
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CERTIFIED DOULA
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Name | AMANDA GARRISON
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Credential | CD
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Telephone | 931-200-0463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 374J00000X
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License Number State | TN
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