MEDICARE: MRS. JEAN L VIAUD-MURAT RN, CLC

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	163WL0100X	Lactation Consultant (Registered Nurse)	4704361014	MI

General Provider Information

NPI Number	:	1780275909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JEAN L VIAUD-MURAT RN, CLC

Provider Business Mailing Address
First Line	:	5261 OCONNOR CT
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-2523
Country	:	US
Telephone Number	:	248-973-5111
Fax Number	:

Provider Business Practice Location Address
First Line	:	5261 OCONNOR CT
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-2523
Country	:	US
Telephone Number	:	248-973-5111
Fax Number	:

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

Provider Enumeration Date	:	01/30/2021
Last Update Date	:	01/30/2021

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