Provider Demographics
NPI:1437426533
Name:NAYLOR, ELIZABETH ROSE BERNADINE (CD, IBCLC, LGSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ROSE BERNADINE
Last Name:NAYLOR
Suffix:
Gender:F
Credentials:CD, IBCLC, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 1ST ST SW
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-3315
Mailing Address - Country:US
Mailing Address - Phone:952-457-3834
Mailing Address - Fax:
Practice Address - Street 1:1731 1ST ST SW
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-3315
Practice Address - Country:US
Practice Address - Phone:952-457-3834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174N00000X, 374J00000X
MN32763104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula