Provider Demographics
NPI:1407309487
Name:JESFJELD, DANAIL (DOULA)
Entity Type:Individual
Prefix:MRS
First Name:DANAIL
Middle Name:
Last Name:JESFJELD
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 1:5172 COORS BLVD SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121-6263
Mailing Address - Country:US
Mailing Address - Phone:505-331-8425
Mailing Address - Fax:
Practice Address - Street 1:5172 COORS BLVD SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-6263
Practice Address - Country:US
Practice Address - Phone:505-331-8425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1407309487Medicaid