Healthcare Provider Details

I. General information

NPI: 1477095131
Provider Name (Legal Business Name): ARIZONA BREASTFEEDING MEDICINE AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2016
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7730 E GREENWAY RD STE 101
SCOTTSDALE AZ
85260
US

IV. Provider business mailing address

7730 E GREENWAY RD STE 101
SCOTTSDALE AZ
85260-1787
US

V. Phone/Fax

Practice location:
  • Phone: 480-508-0861
  • Fax: 480-447-8890
Mailing address:
  • Phone: 480-508-0861
  • Fax: 480-447-8890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. CARA JO RIEK
Title or Position: FAMILY NURSE PRACTITIONER
Credential: DNP, FNP-BC, IBCLC
Phone: 480-208-1490