Provider Demographics
NPI:1962214361
Name:JOHNSON, PAULETTE ALFAYE (DOULA)
Entity type:Individual
Prefix:MRS
First Name:PAULETTE
Middle Name:ALFAYE
Last Name:JOHNSON
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 1:14 HOPKINS BRANCH WAY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBRG
Mailing Address - State:VA
Mailing Address - Zip Code:22406-8219
Mailing Address - Country:US
Mailing Address - Phone:315-415-1297
Mailing Address - Fax:
Practice Address - Street 1:14 HOPKINS BRANCH WAY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBRG
Practice Address - State:VA
Practice Address - Zip Code:22406-8219
Practice Address - Country:US
Practice Address - Phone:315-415-1297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA4677374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty