Provider Demographics
NPI:1184982035
Name:BIELLI, STEPHANIE J (LPN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:J
Last Name:BIELLI
Suffix:
Gender:F
Credentials:LPN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7037 BUCKTAIL RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-9351
Mailing Address - Country:US
Mailing Address - Phone:910-308-6944
Mailing Address - Fax:
Practice Address - Street 1:7037 BUCKTAIL RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-9351
Practice Address - Country:US
Practice Address - Phone:910-308-6944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-29
Last Update Date:2012-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11093251174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN