Provider Demographics
NPI:1689263758
Name:EDDS, BRITTANI (IBCLC)
Entity Type:Individual
Prefix:
First Name:BRITTANI
Middle Name:
Last Name:EDDS
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 1:935 KOHL ST
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-1822
Mailing Address - Country:US
Mailing Address - Phone:303-257-5653
Mailing Address - Fax:
Practice Address - Street 1:935 KOHL ST
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-1822
Practice Address - Country:US
Practice Address - Phone:303-257-5653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2021-02-15
Deactivation Date:2021-01-28
Deactivation Code:
Reactivation Date:2021-02-15
Provider Licenses
StateLicense IDTaxonomies
CO1644073163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant