Provider Demographics
NPI:1780933242
Name:MUHAMMAD, CAMISHA (CLC, DOULA)
Entity type:Individual
Prefix:MRS
First Name:CAMISHA
Middle Name:
Last Name:MUHAMMAD
Suffix:
Gender:F
Credentials:CLC, DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 CHARITY LN SW
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-5000
Mailing Address - Country:US
Mailing Address - Phone:678-973-5621
Mailing Address - Fax:
Practice Address - Street 1:607 CHARITY LN SW
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-5000
Practice Address - Country:US
Practice Address - Phone:678-973-5621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-30
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLALPP35071374J00000X
372500000X, 376J00000X, 376K00000X, 374T00000X, 374K00000X, 174H00000X, 174N00000X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No372500000XNursing Service Related ProvidersChore Provider
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide
No374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner
No174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No172V00000XOther Service ProvidersCommunity Health Worker