Provider Demographics
NPI:1477976587
Name:KAUFFMAN, MARY JOLENE (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:JOLENE
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:JOLENE
Other - Last Name:SETTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:IBCLC
Mailing Address - Street 1:28 PERROTTI LN
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-7453
Mailing Address - Country:US
Mailing Address - Phone:386-383-7949
Mailing Address - Fax:
Practice Address - Street 1:28 PERROTTI LN
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-7453
Practice Address - Country:US
Practice Address - Phone:386-383-7949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-24
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL-23384174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN