Provider Demographics
NPI:1740992056
Name:WARBURTON, KAILEY JEAN (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:KAILEY
Middle Name:JEAN
Last Name:WARBURTON
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 1:1574 CLEAR CREEK LOOP
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-8322
Mailing Address - Country:US
Mailing Address - Phone:425-760-5459
Mailing Address - Fax:
Practice Address - Street 1:1574 CLEAR CREEK LOOP
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-8322
Practice Address - Country:US
Practice Address - Phone:425-760-5459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID67432163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
Provider Identifiers
StateIdentifier IDID TypeIssuer
L-309713OtherIBCLC
ID67432OtherREGISTERED NURSE