Provider Demographics
NPI:1942898556
Name:ABOUNDING GRACE BIRTH SERVICES, LLC
Entity Type:Organization
Organization Name:ABOUNDING GRACE BIRTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:DIXON
Authorized Official - Last Name:EASTER
Authorized Official - Suffix:
Authorized Official - Credentials:CD(DONA)
Authorized Official - Phone:870-562-4186
Mailing Address - Street 1:3562 PIN HOOK RD APT 1217
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-2985
Mailing Address - Country:US
Mailing Address - Phone:615-434-4411
Mailing Address - Fax:
Practice Address - Street 1:3562 PIN HOOK RD APT 1217
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-2985
Practice Address - Country:US
Practice Address - Phone:615-434-4411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty