MEDICARE: LACTATION ROOM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WL0100X	Lactation Consultant (Registered Nurse)	L-12584	MD
2	163W00000X	Registered Nurse	R182063	MD

General Provider Information

NPI Number	:	1033576202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LACTATION ROOM

Provider Business Mailing Address
First Line	:	4912 FLANDERS AVE
Second Line	:
City	:	KENSINGTON
State	:	MD
Zip	:	20895-1231
Country	:	US
Telephone Number	:	301-529-5433
Fax Number	:	301-942-0030

Provider Business Practice Location Address
First Line	:	4912 FLANDERS AVE
Second Line	:
City	:	KENSINGTON
State	:	MD
Zip	:	20895-1231
Country	:	US
Telephone Number	:	301-529-5433
Fax Number	:	301-942-0030

Authorized Official
Title or Position	:	OWNER
Name	:	SARAH BARFIELD-EARLY
Credential	:	RN, IBCLC
Telephone Number	:	301-529-5433

Provider Enumeration Date	:	01/19/2016
Last Update Date	:	01/19/2016

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Directions to “LACTATION ROOM ” Practice Location

Language	Start Address	Practice Location

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