Provider Demographics
NPI:1093969610
Name:MILLER, LAURA (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MILLER
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 1:8 WELLSWEEP DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-2302
Mailing Address - Country:US
Mailing Address - Phone:203-779-5451
Mailing Address - Fax:
Practice Address - Street 1:8 WELLSWEEP DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2302
Practice Address - Country:US
Practice Address - Phone:203-779-5451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT03687310163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant