Provider Demographics
NPI:1932534849
Name:LAND, MACY ELLEN (CD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:MACY
Middle Name:ELLEN
Last Name:LAND
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 WESTBURY TER
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-7673
Mailing Address - Country:US
Mailing Address - Phone:405-816-4361
Mailing Address - Fax:
Practice Address - Street 1:912 WESTBURY TER
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-7673
Practice Address - Country:US
Practice Address - Phone:405-816-4361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
9967374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula