Provider Demographics
NPI:1770930646
Name:AUBERT, DEBRA JANINE (IBCLC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:JANINE
Last Name:AUBERT
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4090 W MUFFIN ST
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99623-4142
Mailing Address - Country:US
Mailing Address - Phone:907-952-4559
Mailing Address - Fax:
Practice Address - Street 1:4090 W MUFFIN ST
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99623-4142
Practice Address - Country:US
Practice Address - Phone:907-952-4559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN