Provider Demographics
NPI:1447036835
Name:KNUDSON, ARIANA LISSELLE (DOULA)
Entity type:Individual
Prefix:
First Name:ARIANA
Middle Name:LISSELLE
Last Name:KNUDSON
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:ARIANA
Other - Middle Name:LISSELLE
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19811 E 47TH TERRACE CT
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-9740
Mailing Address - Country:US
Mailing Address - Phone:864-707-6959
Mailing Address - Fax:
Practice Address - Street 1:19811 E 47TH TERRACE CT
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-9740
Practice Address - Country:US
Practice Address - Phone:864-707-6959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula