Provider Demographics
NPI:1255092433
Name:SUNFLOWER DOULA SERVICE
Entity type:Organization
Organization Name:SUNFLOWER DOULA SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED LABOR DOULA
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIKA
Authorized Official - Middle Name:FAITH
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:CLD
Authorized Official - Phone:907-841-8873
Mailing Address - Street 1:2521 E MOUNTAIN VILLAGE DR STE B539
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7373
Mailing Address - Country:US
Mailing Address - Phone:907-841-8873
Mailing Address - Fax:
Practice Address - Street 1:2662 S WEEPING BIRCH ST
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654
Practice Address - Country:US
Practice Address - Phone:907-841-8873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty