Provider Demographics
NPI:1639666134
Name:AIST, JENNIFER ELIZABETH (IBCLC, RLC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:AIST
Suffix:
Gender:F
Credentials:IBCLC, RLC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ELIZABETH
Other - Last Name:OLIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4700 MARS DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-3725
Mailing Address - Country:US
Mailing Address - Phone:907-563-7048
Mailing Address - Fax:
Practice Address - Street 1:4700 MARS DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-3725
Practice Address - Country:US
Practice Address - Phone:907-602-2974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKL-13281OtherINTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS