Provider Demographics
NPI:1336507128
Name:AVETA BIRTH SERVICES
Entity Type:Organization
Organization Name:AVETA BIRTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LARABIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-374-5780
Mailing Address - Street 1:211 W 17TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4051
Mailing Address - Country:US
Mailing Address - Phone:931-374-5780
Mailing Address - Fax:
Practice Address - Street 1:211 W 17TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4051
Practice Address - Country:US
Practice Address - Phone:931-374-5780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-08
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty