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General NPI Number Information
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NPI Number | 1114740644
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Entity Type | Individual
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Provider Name | EMILY NICOLE BURKHEAD IBCLC
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Gender | Female
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 1020 19TH ST NW STE 150
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City | WASHINGTON
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State | DC
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Zip | 20036-6103
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Country | US
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Telephone | 202-293-5182
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Fax |
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Provider Business Mailing Address
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Address Line | 7479 COLLINS MEADE WAY
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City | ALEXANDRIA
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State | VA
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Zip | 22315-5254
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Country | US
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Telephone | 443-752-6261
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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 | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number | L-302713
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License Number State | GA
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