Healthcare Provider Details

I. General information

NPI: 1356963110
Provider Name (Legal Business Name): VIRTUAL BREASTFEEDING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2020
Last Update Date: 04/08/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 S QUEBEC ST STE A3123
CENTENNIAL CO
80112-4411
US

IV. Provider business mailing address

8200 S QUEBEC ST
CENTENNIAL CO
80112-4411
US

V. Phone/Fax

Practice location:
  • Phone: 858-480-9786
  • Fax:
Mailing address:
  • Phone: 858-480-9786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PHILLINE BENSON
Title or Position: OWNER
Credential: RN, MSN, IBCLC
Phone: 720-441-2889