Provider Demographics
NPI:1629499033
Name:FIELDS, JULIE (IBCLC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:FIELDS
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:PRATT
Mailing Address - State:KS
Mailing Address - Zip Code:67124-1436
Mailing Address - Country:US
Mailing Address - Phone:620-770-6844
Mailing Address - Fax:316-347-7898
Practice Address - Street 1:802 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:PRATT
Practice Address - State:KS
Practice Address - Zip Code:67124-1436
Practice Address - Country:US
Practice Address - Phone:620-770-6844
Practice Address - Fax:316-347-7898
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-02
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSL-41777OtherIBLCE, INTERNATIONAL