Provider Demographics
NPI:1780014779
Name:KANA, KIRA (CPM, LM)
Entity Type:Individual
Prefix:
First Name:KIRA
Middle Name:
Last Name:KANA
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 S MORGAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROUSSARD
Mailing Address - State:LA
Mailing Address - Zip Code:70518-4921
Mailing Address - Country:US
Mailing Address - Phone:337-453-4346
Mailing Address - Fax:337-735-3967
Practice Address - Street 1:715 COOLIDGE ST STE B
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2309
Practice Address - Country:US
Practice Address - Phone:337-412-4373
Practice Address - Fax:208-246-4347
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-12
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMDW.200008176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife