Healthcare Provider Details

I. General information

NPI: 1750029120
Provider Name (Legal Business Name): BRITTNEY RHODES IBCLC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 05/25/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3646 JARRETTSVILLE PIKE
MONKTON MD
21111-1909
US

IV. Provider business mailing address

3646 JARRETTSVILLE PIKE
MONKTON MD
21111-1909
US

V. Phone/Fax

Practice location:
  • Phone: 410-736-1131
  • Fax: 855-710-7254
Mailing address:
  • Phone: 410-736-1131
  • Fax: 855-710-7254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRITTNEY RHODES
Title or Position: OWNER
Credential: RN, IBCLC
Phone: 410-736-1131