Provider Demographics
NPI:1467176362
Name:FOREVER FAMILY FITNESS: BREASTFEEDING SAVVY
Entity Type:Organization
Organization Name:FOREVER FAMILY FITNESS: BREASTFEEDING SAVVY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:JENELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEMETH
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN, IBCLC
Authorized Official - Phone:704-746-2424
Mailing Address - Street 1:58 CLIFTON COUNTRY ROAD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065
Mailing Address - Country:US
Mailing Address - Phone:704-746-2424
Mailing Address - Fax:
Practice Address - Street 1:58 CLIFTON COUNTRY ROAD
Practice Address - Street 2:SUITE 106
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065
Practice Address - Country:US
Practice Address - Phone:704-746-2424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY200426935002OtherCDPHP