Healthcare Provider Details

I. General information

NPI: 1164217907
Provider Name (Legal Business Name): CONNECTIONS LACTATION CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2025
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7592 E PALO VERDE ST
PRESCOTT VALLEY AZ
86314-3235
US

IV. Provider business mailing address

3424 W TANYA TRL
PHOENIX AZ
85086-4328
US

V. Phone/Fax

Practice location:
  • Phone: 928-830-1642
  • Fax: 602-429-8439
Mailing address:
  • Phone: 602-402-0413
  • Fax: 602-429-8439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name: CAROL E KIDD
Title or Position: OWNER/PROVIDER
Credential: IBCLC
Phone: 602-402-0413