=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124947338
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CATHERINE ANN ELIZABETH SELLERS IBCLC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2026
-----------------------------------------------------
Last Update Date | 07/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2927 S KINGSHIGHWAY BLVD
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63139-1008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-268-4070
-----------------------------------------------------
Fax | 314-268-4019
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2927 S KINGSHIGHWAY BLVD
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63139-1008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-268-4070
-----------------------------------------------------
Fax | 314-268-4019
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WL0100X
-----------------------------------------------------
Taxonomy Name | Lactation Consultant (Registered Nurse)
-----------------------------------------------------
License Number | L-322291
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------