Provider Demographics
NPI:1851655583
Name:GIOVANETTI, JEANETTE (IBCLC)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:GIOVANETTI
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 1:387 LOVELL AVE
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-1712
Mailing Address - Country:US
Mailing Address - Phone:610-392-2211
Mailing Address - Fax:
Practice Address - Street 1:387 LOVELL AVE
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-1712
Practice Address - Country:US
Practice Address - Phone:610-392-2211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2023-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAL-309953174N00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No174N00000XOther Service ProvidersLactation Consultant, Non-RN