Healthcare Provider Details

I. General information

NPI: 1033909882
Provider Name (Legal Business Name): KAITLYN PAIGE FARRELL RN, IBCLC, CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7846 AYERDAYL LN
CINCINNATI OH
45255-4436
US

IV. Provider business mailing address

7846 AYERDAYL LN
CINCINNATI OH
45255-4436
US

V. Phone/Fax

Practice location:
  • Phone: 513-502-4943
  • Fax:
Mailing address:
  • Phone: 513-502-5609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-309394
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: