Provider Demographics
NPI:1952874273
Name:BRYANT, JARELLE (DOULA)
Entity Type:Individual
Prefix:
First Name:JARELLE
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6009 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-3555
Mailing Address - Country:US
Mailing Address - Phone:816-548-6618
Mailing Address - Fax:
Practice Address - Street 1:6009 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-3555
Practice Address - Country:US
Practice Address - Phone:816-548-6618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3493-10374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula