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General NPI Number Information
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NPI Number | 1568174589
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Entity Type | Organization
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Legal Business Name | OREM LACTATION CLINIC
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Dates
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Enumeration Date | 12/21/2022
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | OREM COMMUNITY HOSPITAL 331 NORTH 400 WEST
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City | OREM
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State | UT
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Zip | 84057
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Country | US
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Telephone | 801-714-3324
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Fax |
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Provider Business Mailing Address
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Address Line | OREM COMMUNITY HOSPITAL 331 NORTH 400 WEST
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City | OREM
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State | UT
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Zip | 84057
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Country | US
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Telephone | 801-714-3324
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE-LICENSED LACTATION
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Name | HEIDI V FERGUSON
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Credential |
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Telephone | 801-714-3324
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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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