Provider Demographics
NPI:1306284799
Name:GIRARDO, JAYDE MARIE (CPM, LLM)
Entity type:Individual
Prefix:
First Name:JAYDE
Middle Name:MARIE
Last Name:GIRARDO
Suffix:
Gender:F
Credentials:CPM, LLM
Other - Prefix:
Other - First Name:JAYDE
Other - Middle Name:MARIE
Other - Last Name:LOSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DOULA
Mailing Address - Street 1:19359 HWY 16 W
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:AR
Mailing Address - Zip Code:72031
Mailing Address - Country:US
Mailing Address - Phone:501-277-0322
Mailing Address - Fax:
Practice Address - Street 1:19359 HWY 16 W
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:AR
Practice Address - Zip Code:72031
Practice Address - Country:US
Practice Address - Phone:501-277-0322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-07
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARCPM230080299176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty