Provider Demographics
NPI:1891425872
Name:DONAWALD, JESSICA (BIRTH DOULA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:DONAWALD
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 1:6279 PRICKLY LOOP
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-2420
Mailing Address - Country:US
Mailing Address - Phone:407-960-9522
Mailing Address - Fax:
Practice Address - Street 1:6279 PRICKLY LOOP
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-2420
Practice Address - Country:US
Practice Address - Phone:407-960-9522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374J00000X
TN374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula