Provider Demographics
NPI:1629782818
Name:AGAPE MIDWIFERY AND WELLNESS LLC
Entity Type:Organization
Organization Name:AGAPE MIDWIFERY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LUGRAND
Authorized Official - Suffix:
Authorized Official - Credentials:CLC, LCCE, ADVCD/PCD
Authorized Official - Phone:405-819-4904
Mailing Address - Street 1:1608 NORTHCREST DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-7415
Mailing Address - Country:US
Mailing Address - Phone:405-819-4904
Mailing Address - Fax:405-896-8741
Practice Address - Street 1:2322 N INTERSTATE DR STE 2
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-2942
Practice Address - Country:US
Practice Address - Phone:405-819-4904
Practice Address - Fax:405-896-8741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty