Healthcare Provider Details

I. General information

NPI: 1952164204
Provider Name (Legal Business Name): AMY KATHLEEN GAFFNEY RN BSN IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2024
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DELTA CT
FRANKLIN MA
02038-2468
US

IV. Provider business mailing address

10 CHAMPION ST
TEWKSBURY MA
01876-3902
US

V. Phone/Fax

Practice location:
  • Phone: 717-332-2751
  • Fax:
Mailing address:
  • Phone: 617-538-5392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-106377
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: