Provider Demographics
NPI:1851130025
Name:DORANT, DANIEL JOHN (LPN, BIRTH DOULA)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JOHN
Last Name:DORANT
Suffix:
Gender:M
Credentials:LPN, BIRTH DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1980 COMMONWEALTH AVE APT 24
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-5824
Mailing Address - Country:US
Mailing Address - Phone:508-572-5712
Mailing Address - Fax:
Practice Address - Street 1:1980 COMMONWEALTH AVE APT 24
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135-5824
Practice Address - Country:US
Practice Address - Phone:508-572-5712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN94152164W00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No164W00000XNursing Service ProvidersLicensed Practical Nurse