Provider Demographics
NPI:1790579407
Name:BRANSON, LAURI RIDDELL (BIRTH DOULA)
Entity type:Individual
Prefix:MRS
First Name:LAURI
Middle Name:RIDDELL
Last Name:BRANSON
Suffix:
Gender:
Credentials:BIRTH DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 HOLTBY RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-1929
Mailing Address - Country:US
Mailing Address - Phone:661-303-6993
Mailing Address - Fax:
Practice Address - Street 1:415 HOLTBY RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-1929
Practice Address - Country:US
Practice Address - Phone:661-303-6993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5768374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula