Provider Demographics
NPI:1447907886
Name:JESSIE, AMY (CD(DONA))
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:JESSIE
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:LLOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1301 N CHALLENGER DR
Mailing Address - Street 2:
Mailing Address - City:PUEBLO WEST
Mailing Address - State:CO
Mailing Address - Zip Code:81007-1260
Mailing Address - Country:US
Mailing Address - Phone:859-913-0035
Mailing Address - Fax:
Practice Address - Street 1:1301 N CHALLENGER DR
Practice Address - Street 2:
Practice Address - City:PUEBLO WEST
Practice Address - State:CO
Practice Address - Zip Code:81007-1260
Practice Address - Country:US
Practice Address - Phone:859-913-0035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-06
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY14618374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula