Provider Demographics
NPI:1992977086
Name:MCINTOSH, DAPHNE ALAYNE (CPM, LMT)
Entity type:Individual
Prefix:MRS
First Name:DAPHNE
Middle Name:ALAYNE
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:CPM, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2728 BROWN HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-7179
Mailing Address - Country:US
Mailing Address - Phone:615-948-6294
Mailing Address - Fax:
Practice Address - Street 1:613 SHADYCREST LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-5110
Practice Address - Country:US
Practice Address - Phone:615-791-6645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN42176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife