Provider Demographics
NPI:1316786387
Name:HITZLER, JENNIFER BRANDON (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BRANDON
Last Name:HITZLER
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 1:2116 AMANDA MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3735
Mailing Address - Country:US
Mailing Address - Phone:615-390-8068
Mailing Address - Fax:
Practice Address - Street 1:2116 AMANDA MEADOW CT
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-3735
Practice Address - Country:US
Practice Address - Phone:615-390-8068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000119309163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant