Provider Demographics
NPI:1306382874
Name:CULLEN, AMANDA (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:CULLEN
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 1:884 SALTERE RD
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:DE
Mailing Address - Zip Code:19938-9715
Mailing Address - Country:US
Mailing Address - Phone:302-547-8378
Mailing Address - Fax:
Practice Address - Street 1:884 SALTERE RD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:DE
Practice Address - Zip Code:19938-9715
Practice Address - Country:US
Practice Address - Phone:302-547-8378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN