Provider Demographics
NPI:1508228800
Name:MOMMY & BABY LOVE LLC
Entity Type:Organization
Organization Name:MOMMY & BABY LOVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEMERSMA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC,RLC,CCE
Authorized Official - Phone:561-331-4174
Mailing Address - Street 1:PO BOX 17071
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33416-7071
Mailing Address - Country:US
Mailing Address - Phone:561-331-4174
Mailing Address - Fax:
Practice Address - Street 1:457 PALO ALTO DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-1517
Practice Address - Country:US
Practice Address - Phone:561-331-4174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9222031163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty