Provider Demographics
NPI:1336856517
Name:TARVER, TERESA DENEAN (DOULA)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:DENEAN
Last Name:TARVER
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 1:16850 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-3005
Mailing Address - Country:US
Mailing Address - Phone:773-574-9730
Mailing Address - Fax:
Practice Address - Street 1:16850 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-3005
Practice Address - Country:US
Practice Address - Phone:773-574-9730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula