Healthcare Provider Details

I. General information

NPI: 1851713051
Provider Name (Legal Business Name): LACHELLE REECE RN, BSN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2014
Last Update Date: 01/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2927 SW 103RD ST
GAINESVILLE FL
32608-9081
US

IV. Provider business mailing address

2927 SW 103RD ST
GAINESVILLE FL
32608-9081
US

V. Phone/Fax

Practice location:
  • Phone: 352-871-0413
  • Fax:
Mailing address:
  • Phone: 352-871-0413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN9226686
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-27516
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: