MEDICARE: SUSAN J MCCANN CD(DONA)

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14912	OTHER		DONA INTERNATIONAL

General Provider Information

NPI Number	:	1346947728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN J MCCANN CD(DONA)

Provider Business Mailing Address
First Line	:	2501 RAEFORD CT
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-7619
Country	:	US
Telephone Number	:	757-418-3388
Fax Number	:

Provider Business Practice Location Address
First Line	:	2501 RAEFORD CT
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-7619
Country	:	US
Telephone Number	:	757-418-3388
Fax Number	:

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

Provider Enumeration Date	:	02/15/2023
Last Update Date	:	02/15/2023

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Directions to “ SUSAN J MCCANN CD(DONA)” Practice Location

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