Provider Demographics
NPI:1154894392
Name:AHLBORN, FELICIA MICHELE (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:MICHELE
Last Name:AHLBORN
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 PELTON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-3141
Mailing Address - Country:US
Mailing Address - Phone:347-613-2101
Mailing Address - Fax:
Practice Address - Street 1:745 PELTON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-3141
Practice Address - Country:US
Practice Address - Phone:347-613-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-10
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY551374163WW0101X, 163WX0002X, 163WL0100X, 163WX0003X, 163WC0400X, 163WC1500X, 163WM0102X, 163WN0003X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WN0003XNursing Service ProvidersRegistered NurseNeonatal, Low-Risk
No163WP0200XNursing Service ProvidersRegistered NursePediatrics