Provider Demographics
NPI:1275082935
Name:NOBLE, JOELLEN M (IBCLC)
Entity Type:Individual
Prefix:
First Name:JOELLEN
Middle Name:M
Last Name:NOBLE
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 1:134 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:SARDINIA
Mailing Address - State:OH
Mailing Address - Zip Code:45171-9354
Mailing Address - Country:US
Mailing Address - Phone:859-445-8019
Mailing Address - Fax:
Practice Address - Street 1:134 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:SARDINIA
Practice Address - State:OH
Practice Address - Zip Code:45171-9354
Practice Address - Country:US
Practice Address - Phone:859-445-8019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHL-33102174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN