Provider Demographics
NPI:1740729466
Name:NEST COLLABORATIVE NURSING AND LACTATION SERVICES , PC
Entity type:Organization
Organization Name:NEST COLLABORATIVE NURSING AND LACTATION SERVICES , PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAITLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:075-363-6797
Mailing Address - Street 1:2299 SUMMER ST STE 1184
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-4502
Mailing Address - Country:US
Mailing Address - Phone:888-598-1554
Mailing Address - Fax:844-364-2618
Practice Address - Street 1:822 GUILFORD AVE STE 1560
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-3707
Practice Address - Country:US
Practice Address - Phone:888-598-1554
Practice Address - Fax:844-364-2618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-14
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WL0100X, 363LP0200X
MD214487363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty