Healthcare Provider Details

I. General information

NPI: 1538930086
Provider Name (Legal Business Name): OPTIMAL NURTURING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HILL ST
BRISTOL TN
37620-2140
US

IV. Provider business mailing address

800 HILL ST
BRISTOL TN
37620-2140
US

V. Phone/Fax

Practice location:
  • Phone: 423-228-0303
  • Fax:
Mailing address:
  • Phone: 423-228-0303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: HEATHER HUTTON
Title or Position: LACTATION CONSULTANT & OWNER
Credential: BSN, RN, IBCLC, CCM
Phone: 423-228-0303