MEDICARE: SARAH BRASHEAR 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
1	174N00000X	Lactation Consultant (Non-RN)	L-317110

General Provider Information

NPI Number	:	1568265734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH BRASHEAR IBCLC

Provider Business Mailing Address
First Line	:	3389 S TATUM CT
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85297-7809
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1818 E SOUTHERN AVE STE 3A
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85204-5247
Country	:	US
Telephone Number	:	480-235-8473
Fax Number	:

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

Provider Enumeration Date	:	03/31/2025
Last Update Date	:	03/31/2025

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