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General NPI Number Information
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NPI Number | 1194319764
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Entity Type | Organization
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Legal Business Name | BADGERLAND BREASTFEEDING, LLC
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Dates
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Enumeration Date | 02/24/2021
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Last Update Date | 02/24/2021
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Provider Practice Location Address
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Address Line | 17718 MARQUETTE RD
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City | REEDSVILLE
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State | WI
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Zip | 54230-9010
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Country | US
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Telephone | 920-289-8834
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 135
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City | REEDSVILLE
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State | WI
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Zip | 54230
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Country | US
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Telephone | 920-289-8834
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Fax |
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Authorized Official
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Title or Position | IBCLC
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Name | ACACIA ELMER
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Credential | IBCLC
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Telephone | 920-289-8834
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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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