Provider Demographics
NPI:1558186874
Name:VAN VORHIS, JENNIFER K (DOULA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:K
Last Name:VAN VORHIS
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:PO BOX 915
Mailing Address - Street 2:
Mailing Address - City:LUCKEY
Mailing Address - State:OH
Mailing Address - Zip Code:43443-0915
Mailing Address - Country:US
Mailing Address - Phone:419-575-6251
Mailing Address - Fax:
Practice Address - Street 1:407 S STEARNS AVE
Practice Address - Street 2:
Practice Address - City:DESHLER
Practice Address - State:OH
Practice Address - Zip Code:43516-1320
Practice Address - Country:US
Practice Address - Phone:419-278-7640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula