Provider Demographics
NPI:1215794714
Name:JOHNSON-PRELOW, CAROL (DOULA)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:JOHNSON-PRELOW
Suffix:
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 1:2320 DRUSILLA LN, STE A
Mailing Address - Street 2:PMB 2008
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:225-284-3083
Mailing Address - Fax:
Practice Address - Street 1:11949 KING RICHARD DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-6318
Practice Address - Country:US
Practice Address - Phone:225-284-3083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA230444164W00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No164W00000XNursing Service ProvidersLicensed Practical Nurse