Provider Demographics
NPI:1669161790
Name:DEMARTRA WHEAT, MYQUEL M (HHP, DOULA)
Entity type:Individual
Prefix:
First Name:MYQUEL
Middle Name:M
Last Name:DEMARTRA WHEAT
Suffix:
Gender:F
Credentials:HHP, DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-3447
Mailing Address - Country:US
Mailing Address - Phone:910-379-9966
Mailing Address - Fax:
Practice Address - Street 1:307 TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-3447
Practice Address - Country:US
Practice Address - Phone:910-379-9966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No171400000XOther Service ProvidersHealth & Wellness Coach
No172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN