Provider Demographics
NPI:1003240557
Name:GENTHNER, MAGGIE MARIE (DOULA)
Entity Type:Individual
Prefix:MS
First Name:MAGGIE
Middle Name:MARIE
Last Name:GENTHNER
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 22718
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40522-2718
Mailing Address - Country:US
Mailing Address - Phone:606-548-0704
Mailing Address - Fax:
Practice Address - Street 1:106 GREENBRIAR RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2632
Practice Address - Country:US
Practice Address - Phone:606-548-0704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-01
Last Update Date:2013-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula