Healthcare Provider Details

I. General information

NPI: 1942071220
Provider Name (Legal Business Name): BLOOMING BABIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 RAILROAD ST UNIT 1
RICHMOND VT
05477-7749
US

IV. Provider business mailing address

34 BLAIR PARK ROAD SUITE 104, #299
WILLISTON VT
05495
US

V. Phone/Fax

Practice location:
  • Phone: 802-488-5153
  • Fax:
Mailing address:
  • Phone: 802-488-5153
  • 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: ALICE M NORRIS
Title or Position: MANAGER
Credential: RN, IBCLC
Phone: 802-488-5153