Provider Demographics
NPI:1487038261
Name:KERSHAW, JANE (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:KERSHAW
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3270 MAXIE JONES RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-6427
Mailing Address - Country:US
Mailing Address - Phone:615-830-5414
Mailing Address - Fax:
Practice Address - Street 1:3270 MAXIE JONES RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-6427
Practice Address - Country:US
Practice Address - Phone:615-830-5414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-12
Last Update Date:2015-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN52341163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant