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General NPI Number Information
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NPI Number | 1003627837
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Entity Type | Individual
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Provider Name | CHRISTINE MICHELE PERAK RN BSN/IBCLC
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Gender | Female
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 777 BANNOCK ST
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City | DENVER
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State | CO
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Zip | 80204-4597
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Country | US
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Telephone | 303-602-9290
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Fax |
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Provider Business Mailing Address
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Address Line | 4275 E 6TH AVENUE PKWY
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City | DENVER
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State | CO
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Zip | 80220-4908
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Country | US
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Telephone | 620-255-4225
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | 1636901
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License Number State | CO
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