Provider Demographics
NPI:1407612195
Name:BRASFIELD, GINA (DOULA)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:BRASFIELD
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 1:1770 SW CATALONIA ST
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-2071
Mailing Address - Country:US
Mailing Address - Phone:937-241-9638
Mailing Address - Fax:
Practice Address - Street 1:1770 SW CATALONIA ST
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-2071
Practice Address - Country:US
Practice Address - Phone:937-241-9638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL202402350374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula