Healthcare Provider Details

I. General information

NPI: 1043114580
Provider Name (Legal Business Name): FRANCES PENNY RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 ACORN DR
OLD SAYBROOK CT
06475-1233
US

IV. Provider business mailing address

12 ACORN DR
OLD SAYBROOK CT
06475-1233
US

V. Phone/Fax

Practice location:
  • Phone: 860-575-3449
  • Fax:
Mailing address:
  • Phone: 860-575-3449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberR55647
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: