Provider Demographics
NPI:1437724010
Name:DAVIS, TAMARA JAI (DOULA)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:JAI
Last Name:DAVIS
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 1:14912 RUNNING HORSE PL
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-3388
Mailing Address - Country:US
Mailing Address - Phone:706-231-8181
Mailing Address - Fax:
Practice Address - Street 1:14912 RUNNING HORSE PL
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-3388
Practice Address - Country:US
Practice Address - Phone:706-231-8181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula