MEDICARE: SHAWNA BUSSEY MORANT MSW, BIRTH 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

General Provider Information

NPI Number	:	1871108373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWNA BUSSEY MORANT MSW, BIRTH DOULA

Provider Business Mailing Address
First Line	:	8032 MCGARRY TRL
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28214-7649
Country	:	US
Telephone Number	:	803-448-2100
Fax Number	:

Provider Business Practice Location Address
First Line	:	8032 MCGARRY TRL
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28214-7649
Country	:	US
Telephone Number	:	980-224-0435
Fax Number	:

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

Provider Enumeration Date	:	09/11/2020
Last Update Date	:	09/11/2020

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