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General NPI Number Information
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NPI Number | 1164172219
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Entity Type | Organization
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Legal Business Name | MILK IT LACTATION SERVICES LLC
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Dates
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Enumeration Date | 03/23/2022
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | 9600 ADINA LN NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-5263
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Country | US
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Telephone | 505-730-7066
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Fax |
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Provider Business Mailing Address
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Address Line | 9600 ADINA LN NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-5263
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Country | US
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Telephone | 505-730-7066
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CONDOLA GARRETT
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Credential | RN IBCLC
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Telephone | 505-730-7066
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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 |
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License Number State |
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