Provider Demographics
NPI:1073141016
Name:BYLSMA, NATOSHA SAGE-EL (IBCLC)
Entity Type:Individual
Prefix:
First Name:NATOSHA
Middle Name:SAGE-EL
Last Name:BYLSMA
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 1:6920 S CEDAR ST STE 2
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-6924
Mailing Address - Country:US
Mailing Address - Phone:517-574-0802
Mailing Address - Fax:
Practice Address - Street 1:6920 S CEDAR ST STE 2
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-6924
Practice Address - Country:US
Practice Address - Phone:517-574-0802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-27
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL-165844174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN