Provider Demographics
NPI:1285326058
Name:WESTRA, MARY HILL (RN, IBCLC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:HILL
Last Name:WESTRA
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 1:1100 NE 181ST ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-1324
Mailing Address - Country:US
Mailing Address - Phone:786-489-1803
Mailing Address - Fax:
Practice Address - Street 1:1100 NE 181ST ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-1324
Practice Address - Country:US
Practice Address - Phone:786-489-1803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1539462163WL0100X
FLRN1530462163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant