Provider Demographics
NPI:1356230189
Name:TABORN, IMANI YAMIA
Entity type:Individual
Prefix:
First Name:IMANI
Middle Name:YAMIA
Last Name:TABORN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3307 WATKINS RD # 157
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3350
Mailing Address - Country:US
Mailing Address - Phone:984-514-5500
Mailing Address - Fax:
Practice Address - Street 1:3307 WATKINS RD # 157
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3350
Practice Address - Country:US
Practice Address - Phone:984-514-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-27
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN