Provider Demographics
NPI:1295072239
Name:BRUBAKER, JANICE E (DOULA)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:E
Last Name:BRUBAKER
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5694 LONGBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PENTWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49449-8531
Mailing Address - Country:US
Mailing Address - Phone:269-228-0853
Mailing Address - Fax:
Practice Address - Street 1:5694 LONGBRIDGE RD
Practice Address - Street 2:
Practice Address - City:PENTWATER
Practice Address - State:MI
Practice Address - Zip Code:49449-8531
Practice Address - Country:US
Practice Address - Phone:269-228-0853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula