Healthcare Provider Details

I. General information

NPI: 1295399384
Provider Name (Legal Business Name): PEOPLE'S LACTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2019
Last Update Date: 04/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3022 WISCONSIN AVE NW APT 208
WASHINGTON DC
20016
US

IV. Provider business mailing address

3022 WISCONSIN AVE NW APT 208
WASHINGTON DC
20016
US

V. Phone/Fax

Practice location:
  • Phone: 202-817-7470
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: KASSI BROOKE REYES
Title or Position: OWNER, LACTATION CONSULTANT
Credential: RN, IBCCC
Phone: 202-817-7470