Provider Demographics
NPI:1174414601
Name:WORTHON, MIKAYAH I (DOULA)
Entity type:Individual
Prefix:MISS
First Name:MIKAYAH
Middle Name:
Last Name:WORTHON
Suffix:I
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 SW SUMMER CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-4681
Mailing Address - Country:US
Mailing Address - Phone:531-800-7226
Mailing Address - Fax:
Practice Address - Street 1:2604 SW SUMMER CREEK CIR
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-4681
Practice Address - Country:US
Practice Address - Phone:531-800-7226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-12
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula