Organization
AMETHYST BIRTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAVINA FAGAN (OWNER)
(844) 424-7844
Entity
Organization
Contact information
Practice address
1914 J N PEASE PL, CHARLOTTE, NC 28262-7534
(917) 855-5095
Mailing address
1914 J N PEASE PL, CHARLOTTE, NC 28262-7534
(844) 424-7844
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
12/29/2022
Last updated
01/10/2024
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