Provider Demographics
NPI:1669038469
Name:OULMAN-KIRKPATRICK, ALISSA MICHELLE (IBCLC)
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:MICHELLE
Last Name:OULMAN-KIRKPATRICK
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 1:286 M ST STE C
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-4115
Mailing Address - Country:US
Mailing Address - Phone:707-464-7293
Mailing Address - Fax:707-464-6278
Practice Address - Street 1:286 M ST STE C
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-4115
Practice Address - Country:US
Practice Address - Phone:707-464-7293
Practice Address - Fax:707-464-6278
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-95367174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN