Provider Demographics
NPI:1225823370
Name:LINNEY, KELSEA (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:KELSEA
Middle Name:
Last Name:LINNEY
Suffix:
Gender:
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 1:1316 CENTRAL ST APT 1E
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1657
Mailing Address - Country:US
Mailing Address - Phone:847-508-0771
Mailing Address - Fax:
Practice Address - Street 1:1316 CENTRAL ST APT 1E
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1657
Practice Address - Country:US
Practice Address - Phone:847-508-0771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041412177163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant