Healthcare Provider Details

I. General information

NPI: 1659188423
Provider Name (Legal Business Name): ROBIN FABER RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2024
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N117W17780 AUGUSTA CT
GERMANTOWN WI
53022-5644
US

IV. Provider business mailing address

N117W17780 AUGUSTA CT
GERMANTOWN WI
53022-5644
US

V. Phone/Fax

Practice location:
  • Phone: 262-443-8857
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-303514
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: