Provider Demographics
NPI:1457877136
Name:IRWIN, HEATHER MICHELE (BIRTH DOULA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MICHELE
Last Name:IRWIN
Suffix:
Gender:F
Credentials:BIRTH DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 LIBERTY GROVE DR
Mailing Address - Street 2:
Mailing Address - City:FORISTELL
Mailing Address - State:MO
Mailing Address - Zip Code:63348-1184
Mailing Address - Country:US
Mailing Address - Phone:317-345-1679
Mailing Address - Fax:
Practice Address - Street 1:102 LIBERTY GROVE DR
Practice Address - Street 2:
Practice Address - City:FORISTELL
Practice Address - State:MO
Practice Address - Zip Code:63348-1184
Practice Address - Country:US
Practice Address - Phone:317-345-1679
Practice Address - Fax:317-345-1679
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula