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NPI Code Detail

MEDICARE: KIMBERLY ANNE COTTERMAN HAWLEY IBCLC

MEDICARE: KIMBERLY ANNE COTTERMAN HAWLEY IBCLC
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
1174N00000XLactation Consultant (Non-RN)L-301979

General Provider Information

NPI Number : 1568031094
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY ANNE COTTERMAN HAWLEY IBCLC
Provider Business Mailing Address
First Line : 1738 BAY ST SE
Second Line :
City : WASHINGTON
State : DC
Zip : 20003-1646
Country : US
Telephone Number : 202-531-7830
Fax Number :
Provider Business Practice Location Address
First Line : 1738 BAY ST SE
Second Line :
City : WASHINGTON
State : DC
Zip : 20003-1646
Country : US
Telephone Number : 202-531-7830
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2021
Last Update Date : 06/19/2021

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