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General NPI Number Information
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NPI Number | 1841042892
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Entity Type | Individual
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Provider Name | KARMEN SHANICE MCMILLAN DOULA
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Gender | Female
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Dates
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Enumeration Date | 04/03/2024
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Last Update Date | 04/03/2024
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Provider Practice Location Address
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Address Line | 15251 SIESTA KEY WAY APT 304
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City | ROCKVILLE
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State | MD
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Zip | 20850-5507
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Country | US
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Telephone | 210-842-0276
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Fax |
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Provider Business Mailing Address
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Address Line | 10 CENTER DR
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City | BETHESDA
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State | MD
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Zip | 20889-0001
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number | 03774
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State | MD
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