Healthcare Provider Details

I. General information

NPI: 1902155674
Provider Name (Legal Business Name): ELIZABETH IRELAND FLIGHT RN, BSN, IBCLC, ANLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2012
Last Update Date: 08/29/2022
Certification Date: 02/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5741 CLEVELAND ST STE 150
VIRGINIA BEACH VA
23462-1777
US

IV. Provider business mailing address

5741 CLEVELAND ST STE 150
VIRGINIA BEACH VA
23462-1777
US

V. Phone/Fax

Practice location:
  • Phone: 757-422-5502
  • Fax: 757-455-8055
Mailing address:
  • Phone: 757-422-5502
  • Fax: 757-455-8055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number0001182636
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: