Provider Demographics
NPI:1023886298
Name:DRUMM, KRISTEN MELISSA (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MELISSA
Last Name:DRUMM
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 SUGDEN RD
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48386-3687
Mailing Address - Country:US
Mailing Address - Phone:248-770-1702
Mailing Address - Fax:
Practice Address - Street 1:960 SUGDEN RD
Practice Address - Street 2:
Practice Address - City:WHITE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48386-3687
Practice Address - Country:US
Practice Address - Phone:248-770-1702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704338841163W00000X
MIL-313741163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty