Provider Demographics
NPI:1255097267
Name:PEAVY, KIMBERLY M (CERTIFIED DOULA)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:M
Last Name:PEAVY
Suffix:
Gender:F
Credentials:CERTIFIED DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1761 CHERRYLAWN DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-3305
Mailing Address - Country:US
Mailing Address - Phone:419-467-9106
Mailing Address - Fax:
Practice Address - Street 1:1761 CHERRYLAWN DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-3305
Practice Address - Country:US
Practice Address - Phone:419-467-9106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-14
Last Update Date:2021-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula