Healthcare Provider Details

I. General information

NPI: 1609560259
Provider Name (Legal Business Name): ELIZABETH JEAN HESTER IBCLC, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2023
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7648 HIGHWAY 273
REDDING CA
96001-5232
US

IV. Provider business mailing address

7648 HIGHWAY 273
REDDING CA
96001-5232
US

V. Phone/Fax

Practice location:
  • Phone: 530-355-1948
  • Fax:
Mailing address:
  • Phone: 530-355-1948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number766006
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: