Healthcare Provider Details

I. General information

NPI: 1235841461
Provider Name (Legal Business Name): BRITTANIE R SUTTON IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 AUTUMN TER
MAGNOLIA DE
19962-3606
US

IV. Provider business mailing address

146 AUTUMN TER
MAGNOLIA DE
19962-3606
US

V. Phone/Fax

Practice location:
  • Phone: 302-249-8153
  • Fax: 302-246-7024
Mailing address:
  • Phone: 302-249-8153
  • Fax: 302-246-7024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-309886
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: