Healthcare Provider Details

I. General information

NPI: 1740729466
Provider Name (Legal Business Name): NEST COLLABORATIVE NURSING AND LACTATION SERVICES , PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2017
Last Update Date: 02/13/2024
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 GUILFORD AVE STE 1560
BALTIMORE MD
21202-3707
US

IV. Provider business mailing address

2299 SUMMER ST STE 1184
STAMFORD CT
06905-4502
US

V. Phone/Fax

Practice location:
  • Phone: 888-598-1554
  • Fax: 844-364-2618
Mailing address:
  • Phone: 888-598-1554
  • Fax: 844-364-2618

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 Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number214487
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAITLYN ROBERTS
Title or Position: CONTROLLER
Credential:
Phone: 75-363-6797