Healthcare Provider Details

I. General information

NPI: 1841126703
Provider Name (Legal Business Name): WELLFED LACTATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12791 ALANTHUS RD
BRANDY STATION VA
22714-1907
US

IV. Provider business mailing address

12791 ALANTHUS RD
BRANDY STATION VA
22714-1907
US

V. Phone/Fax

Practice location:
  • Phone: 571-316-8265
  • Fax:
Mailing address:
  • Phone: 571-316-8265
  • 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: ASHTON ELIZABETH SWAN
Title or Position: OWNER
Credential: RN, IBCLC
Phone: 571-316-8265