Kourtnee Ann Nicole Stater, CERTIFIED BIRTHDOULA

Primary specialty

DoulaTaxonomy code 374J00000X

License

9404-13 Issued in CA

Practice address

516 Orchid LN
Havelock, NC 28532-2164

Phone

(805) 668-9912

NPI assigned

May 3, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1376288373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 ORCHID LN",
            "city": "HAVELOCK",
            "state": "NC",
            "postal_code": "285322164",
            "telephone_number": "805-668-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 ORCHID LN",
            "city": "HAVELOCK",
            "state": "NC",
            "postal_code": "285322164",
            "telephone_number": "805-668-9912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "516 Orchid Ln",
            "address_purpose": "LOCATION",
            "city": "Havelock",
            "state": "NC",
            "postal_code": "285322164",
            "country_code": "US",
            "telephone_number": "805-668-9912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STATER",
        "first_name": "KOURTNEE",
        "middle_name": "ANN NICOLE",
        "credential": "CERTIFIED BIRTHDOULA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-03",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "CA",
            "license": "9404-13",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Skidmore
• Kerry Smith, SLP
• Maegan Smith, DPT
• Samantha Smith, LCMHCA
• Matthew Robert Snow, MD
• Hannah Steinholtz
• Leanne Stephens, COTA/L
• Deena Joelle Stern, LPT
• Still Ground Counseling, PLLC
• Mary Anna Tayloe

• Doula in Havelock, NC
• Providers in Havelock, NC by specialty
• Doula in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.