Provider Demographics
NPI:1396535613
Name:LAVENDER NEST DOULA LLC
Entity type:Organization
Organization Name:LAVENDER NEST DOULA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:NS
Authorized Official - Last Name:ATANASIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-451-2754
Mailing Address - Street 1:6659 SCHAEFER RD # 1134
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1812
Mailing Address - Country:US
Mailing Address - Phone:313-451-2754
Mailing Address - Fax:
Practice Address - Street 1:8747 WOODWARD AVENUE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202
Practice Address - Country:US
Practice Address - Phone:313-451-2754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty