MEDICARE: ELEANOR GRAY BIRTH AND POSTPARTUM DOULA

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	282NW0100X	Women's Hospital

General Provider Information

NPI Number	:	1225482300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEANOR GRAY BIRTH AND POSTPARTUM DOULA

Provider Business Mailing Address
First Line	:	3540 N ADAMS ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-4318
Country	:	US
Telephone Number	:	617-957-2001
Fax Number	:

Provider Business Practice Location Address
First Line	:	3540 N ADAMS ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-4318
Country	:	US
Telephone Number	:	617-957-2001
Fax Number	:

Authorized Official
Title or Position	:	BIRTH AND POSTPARTUM DOULA
Name	:	ELEANOR GRAY SUTHERLAND-RICE
Credential	:
Telephone Number	:	617-957-2001

Provider Enumeration Date	:	04/14/2016
Last Update Date	:	04/14/2016

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