Kristin Marie Pelletier, IBCLC
Individual provider Active NPI Lactation Consultant (Registered Nurse) · Phoenix, MD
NPI 1104343045 · NPPES record last updated Aug 22, 2017
Key facts
- NPI
- 1104343045
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Lactation Consultant (Registered Nurse) 163WL0100X
- License
- 085071 (CT)
- Practice address
- 2113 Highland Ridge Dr
Phoenix, MD 21131-1217 - Phone
- (410) 443-0022
- NPI assigned
- Aug 22, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085071 | CT | MD | Lactation Consultant (Registered Nurse) |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Registered Nurse) | 163WL0100X | 085071 | CT | Yes |
Addresses
Primary practice location
2113 Highland Ridge Dr
Phoenix, MD 21131-1217
Mailing address
3 Windsor CT
Farmington, CT 06032-1458
Other providers in Phoenix, MD
- Paper Mill Pharmacy, Inc
- Joan Ledvina Parr
- Christopher William Parsons
- Sherry Marie Pearson
- Eva Pechin
- David Alan Perrott
- Phoenix Family Counseling LLC
- Prana Healthcare Staffing
- John Jerome Pycha
- Amy Ruth Rakusin
All providers in Phoenix, MD · Lactation Consultant (Registered Nurse) in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.