Provider Demographics
NPI:1063237071
Name:CHMIELEWSKI, DIANA (IBCLC)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:CHMIELEWSKI
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 SW 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-3412
Mailing Address - Country:US
Mailing Address - Phone:239-895-8939
Mailing Address - Fax:
Practice Address - Street 1:1711 SW 3RD AVE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-3412
Practice Address - Country:US
Practice Address - Phone:239-895-8939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9376094163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant