Provider Demographics
NPI:1356912042
Name:EDEN-STOKES, AMIRA' MARIE
Entity type:Individual
Prefix:
First Name:AMIRA'
Middle Name:MARIE
Last Name:EDEN-STOKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMIRA
Other - Middle Name:MARIE
Other - Last Name:STOKES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DT
Mailing Address - Street 1:10999 RED RUN BLVD STE 205M-246
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3261
Mailing Address - Country:US
Mailing Address - Phone:443-621-5747
Mailing Address - Fax:
Practice Address - Street 1:351 PALADIUM CT
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-1398
Practice Address - Country:US
Practice Address - Phone:443-621-5747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-05
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula