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NPI Code Detail

MEDICARE: MISSOURI COMMUNITY DOULA COUNCIL

MEDICARE: MISSOURI COMMUNITY DOULA COUNCIL
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
1374J00000XDoula

General Provider Information

NPI Number : 1528880564
Entity Type Code : Organization
Provider Name (Legal Business Name) : MISSOURI COMMUNITY DOULA COUNCIL
Provider Business Mailing Address
First Line : 2000 E BROADWAY # 109
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-6009
Country : US
Telephone Number : 913-638-0716
Fax Number :
Provider Business Practice Location Address
First Line : 40 N FLORISSANT RD
Second Line :
City : FERGUSON
State : MO
Zip : 63135-2332
Country : US
Telephone Number : 913-638-0716
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SHERRY LENORE PAYNE
Credential :
Telephone Number : 913-638-0716
Provider Enumeration Date : 10/30/2024
Last Update Date : 10/30/2024

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Directions to “MISSOURI COMMUNITY DOULA COUNCIL ” Practice Location

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