MEDICARE: TWIN CITIES LACTATION

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	174N00000X	Lactation Consultant (Non-RN)

General Provider Information

NPI Number	:	1548061054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TWIN CITIES LACTATION

Provider Business Mailing Address
First Line	:	1029 HAWTHORNE AVE E
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55106-2013
Country	:	US
Telephone Number	:	952-237-6478
Fax Number	:

Provider Business Practice Location Address
First Line	:	1029 HAWTHORNE AVE E
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55106-2013
Country	:	US
Telephone Number	:	952-237-6478
Fax Number	:

Authorized Official
Title or Position	:	LACTATION CONSULTANT
Name	:	KAYTEE ELISABETH CRAWFORD
Credential	:	IBCLC
Telephone Number	:	952-237-6478

Provider Enumeration Date	:	03/20/2025
Last Update Date	:	03/20/2025

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