Provider Demographics
NPI:1700202777
Name:ZOE ETKIN
Entity type:Organization
Organization Name:ZOE ETKIN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, DOULA
Authorized Official - Prefix:
Authorized Official - First Name:ZOE
Authorized Official - Middle Name:
Authorized Official - Last Name:ETKIN
Authorized Official - Suffix:
Authorized Official - Credentials:CLD, CPD
Authorized Official - Phone:901-336-4168
Mailing Address - Street 1:10727 LAWLER ST APT 11
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-5464
Mailing Address - Country:US
Mailing Address - Phone:901-336-4168
Mailing Address - Fax:
Practice Address - Street 1:10727 LAWLER ST APT 11
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-5464
Practice Address - Country:US
Practice Address - Phone:901-336-4168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty