Provider Demographics
NPI:1780229088
Name:SINGH, KAVITA K (IBCLC)
Entity Type:Individual
Prefix:
First Name:KAVITA
Middle Name:K
Last Name:SINGH
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 1:4028 SWEET SHADOW AVE
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-7399
Mailing Address - Country:US
Mailing Address - Phone:520-360-9274
Mailing Address - Fax:
Practice Address - Street 1:4028 SWEET SHADOW AVE
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-7399
Practice Address - Country:US
Practice Address - Phone:520-360-9274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-10
Last Update Date:2019-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN383787163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant