Provider Demographics
NPI:1770868283
Name:GOTHBERG, ERIKA CORRINE (BIRTH DOULA)
Entity Type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:CORRINE
Last Name:GOTHBERG
Suffix:
Gender:F
Credentials:BIRTH DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22500 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-9400
Mailing Address - Country:US
Mailing Address - Phone:269-753-1312
Mailing Address - Fax:
Practice Address - Street 1:22500 NORTH AVE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-9400
Practice Address - Country:US
Practice Address - Phone:269-753-1312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-15
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula