Amanda Harris, RN IBCLC

Individual provider Active NPI Lactation Consultant (Registered Nurse) · Delafield, WI

NPI 1033976337 · NPPES record last updated Mar 4, 2024

Key facts

NPI
1033976337
Entity type
Individual (NPI type 1)
Primary specialty
Lactation Consultant (Registered Nurse) 163WL0100X
License
226715-30 (WI)
Practice address
W307N1497 Golf Rd
Delafield, WI 53018-2112
Phone
(262) 204-7574
NPI assigned
Mar 4, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
226715-30WIMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Latched Lake Country LLC Lactation Consultant Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 226715-30 WI Yes

Addresses

Primary practice location

W307N1497 Golf Rd
Delafield, WI 53018-2112

Mailing address

557 N 63Rd St
Wauwatosa, WI 53213-4173
Phone (414) 403-4037

Other providers in Delafield, WI

All providers in Delafield, WI · Lactation Consultant (Registered Nurse) in Wisconsin

Sources for this page

Verify at the official NPI Registry.