MEDICARE: MRS. DONNA MARIE ROSAVES CD 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	374J00000X	Doula	CD(DONA)	IN

General Provider Information

NPI Number	:	1841632015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DONNA MARIE ROSAVES CD DOULA

Provider Business Mailing Address
First Line	:	9228 W 158TH CT
Second Line	:
City	:	LOWELL
State	:	IN
Zip	:	46356-9380
Country	:	US
Telephone Number	:	219-678-3765
Fax Number	:

Provider Business Practice Location Address
First Line	:	9228 W 158TH CT
Second Line	:
City	:	LOWELL
State	:	IN
Zip	:	46356-9380
Country	:	US
Telephone Number	:	219-678-3765
Fax Number	:

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

Provider Enumeration Date	:	07/29/2013
Last Update Date	:	07/29/2013

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