Provider Demographics
NPI:1770287831
Name:JAM FAMILY DOULA SERVICES
Entity type:Organization
Organization Name:JAM FAMILY DOULA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:MRS
Authorized Official - First Name:TWINETTE
Authorized Official - Middle Name:RAVENELL
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:CPD, CBD, CBE, CBC
Authorized Official - Phone:770-680-8356
Mailing Address - Street 1:PO BOX 261
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38088-0261
Mailing Address - Country:US
Mailing Address - Phone:770-680-8356
Mailing Address - Fax:
Practice Address - Street 1:2741 LAURELCREST CV
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38133-8134
Practice Address - Country:US
Practice Address - Phone:770-680-8356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAM FAMILY TRAVELS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty