=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548131063
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MILKMED LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2025
-----------------------------------------------------
Last Update Date | 09/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5250 FOREST RD
-----------------------------------------------------
City | MINNETONKA
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55345-4329
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 612-201-9759
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5250 FOREST RD
-----------------------------------------------------
City | MINNETONKA
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55345-4329
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LACTATION CONSULTANT
-----------------------------------------------------
Name | VIRGINIA ANNE POLLOCK
-----------------------------------------------------
Credential | MPH, IBCLC
-----------------------------------------------------
Telephone | 612-201-9759
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174N00000X
-----------------------------------------------------
Taxonomy Name | Lactation Consultant (Non-RN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------