Provider Demographics
NPI:1487101184
Name:STADTER, TRACY (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:STADTER
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 1:503 LAMBETH PL
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-3007
Mailing Address - Country:US
Mailing Address - Phone:302-690-0059
Mailing Address - Fax:
Practice Address - Street 1:503 LAMBETH PL
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-3007
Practice Address - Country:US
Practice Address - Phone:302-690-0059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL10016417163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEL10016417OtherREGISTERED NURSE
DE19714303OtherLACTATION CONSULTANT-RN
DE1996105991OtherBREASTFEEDING AND MORE, INC.