Provider Demographics
NPI:1144094657
Name:STAFFORD, MONICA (DOULA CERTIFIED)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:STAFFORD
Suffix:
Gender:F
Credentials:DOULA CERTIFIED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 13111
Mailing Address - Street 2:
Mailing Address - City:KEAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96749-9231
Mailing Address - Country:US
Mailing Address - Phone:808-724-4496
Mailing Address - Fax:
Practice Address - Street 1:HC 3 BOX 13111
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749-9231
Practice Address - Country:US
Practice Address - Phone:808-724-4496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-14
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula