Provider Demographics
NPI:1770353070
Name:CHATTANOOGA LACTATION, LLC
Entity type:Organization
Organization Name:CHATTANOOGA LACTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:LAURA
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC
Authorized Official - Phone:423-619-3622
Mailing Address - Street 1:5879 CROOKED CREEK DR
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6571
Mailing Address - Country:US
Mailing Address - Phone:423-619-3622
Mailing Address - Fax:
Practice Address - Street 1:6845 MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-6561
Practice Address - Country:US
Practice Address - Phone:423-619-3622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty