Provider Demographics
NPI:1407453327
Name:THE NURTURED MOTHER, LLC
Entity Type:Organization
Organization Name:THE NURTURED MOTHER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SODANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-266-3966
Mailing Address - Street 1:22940 WHITE OAK LN
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-4326
Mailing Address - Country:US
Mailing Address - Phone:239-266-3966
Mailing Address - Fax:
Practice Address - Street 1:22940 WHITE OAK LN
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-4326
Practice Address - Country:US
Practice Address - Phone:239-266-3966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-04
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty