Provider Demographics
NPI:1477397008
Name:SHIFRISS, ABIGAIL DEVORA ANNE (CERTIFIED DOULA)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:DEVORA ANNE
Last Name:SHIFRISS
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 1:111 E HARVARD ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1735
Mailing Address - Country:US
Mailing Address - Phone:812-327-6618
Mailing Address - Fax:
Practice Address - Street 1:1419 RIVERSIDE AVE STE C
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4377
Practice Address - Country:US
Practice Address - Phone:812-327-6618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula