Healthcare Provider Details
I. General information
NPI: 1437922697
Provider Name (Legal Business Name): VIRTUAL BREASTFEEDING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/31/2023
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8200 S QUEBEC ST # A3123
CENTENNIAL CO
80112-4411
US
IV. Provider business mailing address
7068 CHESTNUT HILL ST
HIGHLANDS RANCH CO
80130-5106
US
V. Phone/Fax
- Phone: 720-407-5786
- Fax:
- Phone: 858-480-9786
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WL0100X |
| Taxonomy | Lactation Consultant (Registered Nurse) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PHILLINE
BENSON
Title or Position: CEO
Credential: RN, MSN, IBCLC
Phone: 858-480-9786