Provider Demographics
NPI:1669279931
Name:BROGGIN, LAURA ANN ELIZABETH (CERTIFIED DOULA)
Entity type:Individual
Prefix:
First Name:LAURA ANN
Middle Name:ELIZABETH
Last Name:BROGGIN
Suffix:
Gender:
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 1:4761 SUGAR HILL RD
Mailing Address - Street 2:
Mailing Address - City:BROOKNEAL
Mailing Address - State:VA
Mailing Address - Zip Code:24528-3244
Mailing Address - Country:US
Mailing Address - Phone:434-221-2959
Mailing Address - Fax:
Practice Address - Street 1:4761 SUGAR HILL RD
Practice Address - Street 2:
Practice Address - City:BROOKNEAL
Practice Address - State:VA
Practice Address - Zip Code:24528-3244
Practice Address - Country:US
Practice Address - Phone:434-221-2959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-25
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula