MEDICARE: THE BREAST NURSE 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)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1043057532	OTHER	ID	NPI

General Provider Information

NPI Number	:	1154154920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE BREAST NURSE LLC

Provider Business Mailing Address
First Line	:	1834 BROADVIEW DR
Second Line	:
City	:	LEWISTON
State	:	ID
Zip	:	83501-3962
Country	:	US
Telephone Number	:	208-305-1732
Fax Number	:

Provider Business Practice Location Address
First Line	:	1834 BROADVIEW DR
Second Line	:
City	:	LEWISTON
State	:	ID
Zip	:	83501-3962
Country	:	US
Telephone Number	:	208-305-1732
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	K'LEE LYNAE KASPER
Credential	:	BSN, RN, IBCLC
Telephone Number	:	208-305-1732

Provider Enumeration Date	:	08/26/2024
Last Update Date	:	08/26/2024

Similar Medicare Providers

1043057532 — K'LEE LYNAE KASPER BSN, RN, IBCLC
Practice Location Address:

1834 BROADVIEW DR
LEWISTON, ID
83501-3962

Practice Phone: 208-305-1732
Practice Fax:

1992658439 — BROOKE PEIDAN PFAFF
Practice Location Address:

531 BRYDEN AVE
LEWISTON, ID
83501-4438

Practice Phone: 208-798-1646
Practice Fax: 208-798-5568

1023496908 — ANITA RINGERING NP
Practice Location Address:

336 WARNER DR STE 4
LEWISTON, ID
83501-4441

Practice Phone: 208-413-3835
Practice Fax: 208-795-8553

1619611415 — MRS. ESTHER HENTER AGNP-C
Practice Location Address:

415 6TH ST
LEWISTON, ID
83501-2431

Practice Phone: 208-799-5540
Practice Fax:

1982618112 — DR. SAMUEL C. BIELIGK M.D.
Practice Location Address:

415 6TH ST
LEWISTON, ID
83501

Practice Phone: 208-743-7612
Practice Fax: 208-746-4802

1063364412 — STACEY LYNN FORSMAN
Practice Location Address:

531 BRYDEN AVE
LEWISTON, ID
83501-4438

Practice Phone: 208-798-1646
Practice Fax: 208-798-1646

Directions to “THE BREAST NURSE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.