MEDICARE: SHYNESE BRIANA LAKAY'LYNN ALEXANDER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula	UV202193	MO

General Provider Information

NPI Number	:	1215764113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHYNESE BRIANA LAKAY'LYNN ALEXANDER

Provider Business Mailing Address
First Line	:	601 W BUSINESS LOOP 70 STE 214B
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-2566
Country	:	US
Telephone Number	:	573-289-7667
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 W BUSINESS LOOP 70 STE 214B
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-2566
Country	:	US
Telephone Number	:	573-289-7667
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	09/16/2024

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Directions to “ SHYNESE BRIANA LAKAY'LYNN ALEXANDER ” Practice Location

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