Provider Demographics
NPI:1780476457
Name:MOTHER NURTURE LACTATION CONSULTING, LLC
Entity type:Organization
Organization Name:MOTHER NURTURE LACTATION CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNDQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:BS, BSN, RN, IBCLC
Authorized Official - Phone:208-241-1013
Mailing Address - Street 1:396 PHILBIN RD
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83202-7071
Mailing Address - Country:US
Mailing Address - Phone:208-241-1013
Mailing Address - Fax:
Practice Address - Street 1:396 PHILBIN RD
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83202-7071
Practice Address - Country:US
Practice Address - Phone:208-241-1013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty