Healthcare Provider Details

I. General information

NPI: 1336069806
Provider Name (Legal Business Name): KATELYN KLEVEN IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1813 BRACKETT AVE
EAU CLAIRE WI
54701-5040
US

IV. Provider business mailing address

13667 42ND AVE
CHIPPEWA FALLS WI
54729-5697
US

V. Phone/Fax

Practice location:
  • Phone: 715-204-4686
  • Fax:
Mailing address:
  • Phone: 520-678-3765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: