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General NPI Number Information
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NPI Number | 1184417222
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Entity Type | Organization
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Legal Business Name | SOUTHWEST MINNESOTA LACTATION AND BEYOND, LLC
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 348 W MAIN ST STE 202
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City | MARSHALL
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State | MN
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Zip | 56258-1371
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Country | US
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Telephone | 507-401-2688
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Fax |
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Provider Business Mailing Address
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Address Line | 425 241ST ST
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City | BALATON
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State | MN
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Zip | 56115-1107
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Country | US
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Telephone | 507-430-0636
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNA ERICKSON
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Credential | CNM, IBCLC
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Telephone | 507-430-0636
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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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Taxonomy #2
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State |
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