Provider Demographics
NPI:1558683722
Name:ST. PETER, ANTINA AVRY (CD (DONA))
Entity Type:Individual
Prefix:MRS
First Name:ANTINA
Middle Name:AVRY
Last Name:ST. PETER
Suffix:
Gender:F
Credentials:CD (DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 CENTENNIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2304
Mailing Address - Country:US
Mailing Address - Phone:785-259-5974
Mailing Address - Fax:
Practice Address - Street 1:2215 CENTENNIAL BLVD
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2304
Practice Address - Country:US
Practice Address - Phone:785-259-5974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula