Provider Demographics
NPI:1497015135
Name:SISTAGIRL MIDWIFERY
Entity Type:Organization
Organization Name:SISTAGIRL MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED MIDWIFE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAYVON
Authorized Official - Middle Name:DUPREE
Authorized Official - Last Name:MUHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:CPM
Authorized Official - Phone:888-514-3055
Mailing Address - Street 1:3956 RIVERS AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-7023
Mailing Address - Country:US
Mailing Address - Phone:888-514-3055
Mailing Address - Fax:
Practice Address - Street 1:3956 RIVERS AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-7023
Practice Address - Country:US
Practice Address - Phone:888-514-3055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-28
Last Update Date:2012-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0048176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty