Provider Demographics
NPI:1457172868
Name:MICHEL, BRYANNA IMANI (DOULA)
Entity type:Individual
Prefix:
First Name:BRYANNA
Middle Name:IMANI
Last Name:MICHEL
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 1:3853 NW 26TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-2081
Mailing Address - Country:US
Mailing Address - Phone:352-214-5480
Mailing Address - Fax:
Practice Address - Street 1:3853 NW 26TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-2081
Practice Address - Country:US
Practice Address - Phone:352-214-5480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty