Provider Demographics
NPI:1275867897
Name:HUMPHREY, BOBBIE LEANN (CD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:BOBBIE
Middle Name:LEANN
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5332 CARROLL WAREHIME RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21102-3112
Mailing Address - Country:US
Mailing Address - Phone:443-375-6829
Mailing Address - Fax:
Practice Address - Street 1:5332 CARROLL WAREHIME RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MD
Practice Address - Zip Code:21102-3112
Practice Address - Country:US
Practice Address - Phone:443-375-6829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula