Provider Demographics
NPI:1720842602
Name:MOMMAS BEST LACTATION, LLC
Entity Type:Organization
Organization Name:MOMMAS BEST LACTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:K
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN, IBCLC
Authorized Official - Phone:317-698-8542
Mailing Address - Street 1:9958 BRITTAINS WAY
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46158-7168
Mailing Address - Country:US
Mailing Address - Phone:317-698-8542
Mailing Address - Fax:
Practice Address - Street 1:9958 BRITTAINS WAY
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-7168
Practice Address - Country:US
Practice Address - Phone:317-698-8542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty