Provider Demographics
NPI:1720828890
Name:NURISHED LACTATION
Entity type:Organization
Organization Name:NURISHED LACTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNDER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GEFT
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:847-791-8338
Mailing Address - Street 1:9333 HARDING AVE APT SUITE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60203-1320
Mailing Address - Country:US
Mailing Address - Phone:847-791-8338
Mailing Address - Fax:
Practice Address - Street 1:9333 HARDING AVE APT SUITE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60203-1320
Practice Address - Country:US
Practice Address - Phone:847-791-8338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty