Provider Demographics
NPI:1376340992
Name:SHANK, KYRA ANNETTE (CERTIFIED DOULA)
Entity type:Individual
Prefix:MRS
First Name:KYRA
Middle Name:ANNETTE
Last Name:SHANK
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 1:1360 N RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT SOLON
Mailing Address - State:VA
Mailing Address - Zip Code:22843-2342
Mailing Address - Country:US
Mailing Address - Phone:540-810-3084
Mailing Address - Fax:
Practice Address - Street 1:600 HOPEMAN PKWY
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-1830
Practice Address - Country:US
Practice Address - Phone:540-810-3084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-01
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula