Healthcare Provider Details

I. General information

NPI: 1508790106
Provider Name (Legal Business Name): BRIANNA LEE JOCHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 ARTHUR LN
METAMORA IL
61548-9370
US

IV. Provider business mailing address

1122 ARTHUR LN
METAMORA IL
61548-9370
US

V. Phone/Fax

Practice location:
  • Phone: 309-414-4315
  • Fax: 309-717-0356
Mailing address:
  • Phone: 309-414-4315
  • Fax: 309-717-0356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number174400000X
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: