Healthcare Provider Details

I. General information

NPI: 1588491146
Provider Name (Legal Business Name): ASHLEY JAKUBOWSKI IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2024
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4504 BROOKWOOD DR
HIGHLANDS RANCH CO
80130-8847
US

IV. Provider business mailing address

4504 BROOKWOOD DR
HIGHLANDS RANCH CO
80130-8847
US

V. Phone/Fax

Practice location:
  • Phone: 720-361-6311
  • Fax:
Mailing address:
  • Phone: 720-361-6311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-319375
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: