Provider Demographics
NPI:1871383133
Name:MICHAUD, STEPHANIA MEDEJE (RN, BSN, IBCLC)
Entity type:Individual
Prefix:
First Name:STEPHANIA
Middle Name:MEDEJE
Last Name:MICHAUD
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5284 SANCERRE CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-7476
Mailing Address - Country:US
Mailing Address - Phone:561-584-1772
Mailing Address - Fax:
Practice Address - Street 1:17473 ASHCOMB WAY
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-6517
Practice Address - Country:US
Practice Address - Phone:813-291-4695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL-312793163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant