Provider Demographics
NPI:1326802240
Name:BAUMGARTNER, JULIE (IBCLC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:BAUMGARTNER
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 KING ST UNIT 312
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32085-7713
Mailing Address - Country:US
Mailing Address - Phone:727-992-3843
Mailing Address - Fax:
Practice Address - Street 1:99 KING ST UNIT 312
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32085-7713
Practice Address - Country:US
Practice Address - Phone:727-992-3843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2025-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-314544174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN