Provider Demographics
NPI:1407613797
Name:EWEN, ALEXIS SHAMAR (LABOR & BIRTH DOULA)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:SHAMAR
Last Name:EWEN
Suffix:
Gender:F
Credentials:LABOR & BIRTH DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3074 ROLFE RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-9284
Mailing Address - Country:US
Mailing Address - Phone:517-404-4937
Mailing Address - Fax:
Practice Address - Street 1:3074 ROLFE RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-9284
Practice Address - Country:US
Practice Address - Phone:517-404-4937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula