Provider Demographics
NPI:1871278945
Name:VEGAS FAMILY DOULAS
Entity type:Organization
Organization Name:VEGAS FAMILY DOULAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOULA
Authorized Official - Prefix:
Authorized Official - First Name:AISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FANNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-533-6440
Mailing Address - Street 1:5575 SIMMONS ST # 1-127
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-9009
Mailing Address - Country:US
Mailing Address - Phone:702-533-6440
Mailing Address - Fax:
Practice Address - Street 1:7381 PRAIRIE FALCON RD STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0812
Practice Address - Country:US
Practice Address - Phone:702-907-6378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty