Provider Demographics
NPI:1174497309
Name:PFISTER, JILLIAN ROSE (MPH, IBCLC)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:ROSE
Last Name:PFISTER
Suffix:
Gender:F
Credentials:MPH, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 CINNAMON DR
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3124
Mailing Address - Country:US
Mailing Address - Phone:864-640-2273
Mailing Address - Fax:
Practice Address - Street 1:415 CINNAMON DR
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3124
Practice Address - Country:US
Practice Address - Phone:864-640-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL-312613174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN