MEDICARE: MRS. JENNIFER LYNN REMEIKA CPM, IBCLC, CALM

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	176B00000X	Midwife	LM256	CA
2	374J00000X	Doula
3	174N00000X	Lactation Consultant (Non-RN)

General Provider Information

NPI Number	:	1134451263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER LYNN REMEIKA CPM, IBCLC, CALM

Provider Business Mailing Address
First Line	:	936 LIGHTHOUSE AVE
Second Line	:
City	:	PACIFIC GROVE
State	:	CA
Zip	:	93950-2457
Country	:	US
Telephone Number	:	808-639-2430
Fax Number	:

Provider Business Practice Location Address
First Line	:	936 LIGHTHOUSE AVE
Second Line	:
City	:	PACIFIC GROVE
State	:	CA
Zip	:	93950-2457
Country	:	US
Telephone Number	:	808-639-2430
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2010
Last Update Date	:	03/30/2011

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