Healthcare Provider Details

I. General information

NPI: 1356107122
Provider Name (Legal Business Name): NATALIE WONDERS RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2024
Last Update Date: 02/28/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5984 S TAFT WAY
LITTLETON CO
80127-2311
US

IV. Provider business mailing address

5984 S TAFT WAY
LITTLETON CO
80127-2311
US

V. Phone/Fax

Practice location:
  • Phone: 720-364-1707
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number0203821
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: