Provider Demographics
NPI:1114591187
Name:PERALTA, BRITTANY M (RN, BSN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:M
Last Name:PERALTA
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 MYRTLE DR APT 4207
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-8268
Mailing Address - Country:US
Mailing Address - Phone:605-628-2465
Mailing Address - Fax:
Practice Address - Street 1:520 MYRTLE DR APT 4207
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-8268
Practice Address - Country:US
Practice Address - Phone:605-628-2465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-14
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN150389163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant