Provider Demographics
NPI:1992402481
Name:DOULA LIFE
Entity type:Organization
Organization Name:DOULA LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BIRTH DOULA
Authorized Official - Prefix:
Authorized Official - First Name:TALITHA
Authorized Official - Middle Name:CUMI
Authorized Official - Last Name:MCGIRT
Authorized Official - Suffix:
Authorized Official - Credentials:BIRTH DOULA
Authorized Official - Phone:424-209-2370
Mailing Address - Street 1:3111 S VALLEY VIEW BLVD STE A220
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-7702
Mailing Address - Country:US
Mailing Address - Phone:424-209-7320
Mailing Address - Fax:
Practice Address - Street 1:3111 S VALLEY VIEW BLVD STE A220
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-7702
Practice Address - Country:US
Practice Address - Phone:424-209-7320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV02012023641551Medicaid