Healthcare Provider Details

I. General information

NPI: 1760975452
Provider Name (Legal Business Name): SARA ANN ALANIS RN IBCLC IFS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2018
Last Update Date: 11/05/2022
Certification Date: 11/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 STATE ROUTE 101 STE 8
BEDFORD NH
03110-5036
US

IV. Provider business mailing address

6 SPRAGUE MILL RD
BEDFORD NH
03110-4243
US

V. Phone/Fax

Practice location:
  • Phone: 646-653-1642
  • Fax:
Mailing address:
  • Phone: 603-275-7350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-108047
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: