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NPI Code Detail

MEDICARE: NANCY HOLTZMAN RN IBCLC RLC CPN

MEDICARE:   NANCY  HOLTZMAN  RN IBCLC RLC CPN
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
1163WL0100XLactation Consultant (Registered Nurse)MA RN LICENSE: 19124MA
2163WL0100XLactation Consultant (Registered Nurse)IBCLC NUMBER: L-1457MA

General Provider Information

NPI Number : 1427440171
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY HOLTZMAN RN IBCLC RLC CPN
Provider Business Mailing Address
First Line : 64 LEDGE HILL RD
Second Line :
City : WEST ROXBURY
State : MA
Zip : 02132-5027
Country : US
Telephone Number : 617-803-5614
Fax Number :
Provider Business Practice Location Address
First Line : 64 LEDGE HILL RD
Second Line :
City : WEST ROXBURY
State : MA
Zip : 02132-5027
Country : US
Telephone Number : 617-803-5614
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2015
Last Update Date : 03/04/2015

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