Provider Demographics
NPI:1518444934
Name:NELSON, JA'NIECE (DONA DOULA)
Entity Type:Individual
Prefix:MRS
First Name:JA'NIECE
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:DONA DOULA
Other - Prefix:MRS
Other - First Name:JA'NIECE
Other - Middle Name:
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JA'NIECE CD(DONA)
Mailing Address - Street 1:944 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:IL
Mailing Address - Zip Code:60417-1527
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:944 CHARLES ST
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:IL
Practice Address - Zip Code:60417-1527
Practice Address - Country:US
Practice Address - Phone:773-620-1957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula