Provider Demographics
NPI:1386000131
Name:NEXT GENERATION LACTATION SERVICE
Entity Type:Organization
Organization Name:NEXT GENERATION LACTATION SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BIRNEY
Authorized Official - Suffix:
Authorized Official - Credentials:CNM, CLC
Authorized Official - Phone:517-574-0802
Mailing Address - Street 1:3333 S PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-4795
Mailing Address - Country:US
Mailing Address - Phone:517-574-0802
Mailing Address - Fax:
Practice Address - Street 1:3333 S PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-4795
Practice Address - Country:US
Practice Address - Phone:517-574-0802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-10
Last Update Date:2016-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service