Provider Demographics
NPI:1588161376
Name:DAGGETT, JESSICA NICOLE (DOULA, CBED)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:NICOLE
Last Name:DAGGETT
Suffix:
Gender:F
Credentials:DOULA, CBED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1979 MCCARTER LN
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5760
Mailing Address - Country:US
Mailing Address - Phone:541-513-2792
Mailing Address - Fax:
Practice Address - Street 1:1979 MCCARTER LN
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5760
Practice Address - Country:US
Practice Address - Phone:541-513-2792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-09
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula