MEDICARE: EMBRACE LACTATION SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WL0100X	Lactation Consultant (Registered Nurse)

General Provider Information

NPI Number	:	1114855335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMBRACE LACTATION SERVICES LLC

Provider Business Mailing Address
First Line	:	6451 S 28TH WEST AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74132-1340
Country	:	US
Telephone Number	:	405-202-9426
Fax Number	:

Provider Business Practice Location Address
First Line	:	6451 S 28TH WEST AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74132-1340
Country	:	US
Telephone Number	:	405-202-9426
Fax Number	:

Authorized Official
Title or Position	:	LACTATION CONSULTANT
Name	:	MRS. RACHELLE SMITH
Credential	:	BSN, RN, IBCLC
Telephone Number	:	405-202-9426

Provider Enumeration Date	:	05/08/2026
Last Update Date	:	05/08/2026

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