Suzanne W Anderson, RN, IBCLC

Individual provider Active NPI Lactation Consultant (Non-RN) · Sandia Park, NM

NPI 1154856102 · NPPES record last updated Apr 27, 2017

Key facts

NPI
1154856102
Entity type
Individual (NPI type 1)
Primary specialty
Lactation Consultant (Non-RN) 174N00000X
License
L-10364 (NM)
Practice address
30 McLaughlin LN
Sandia Park, NM 87047-6802
Phone
(505) 306-1091
NPI assigned
Apr 27, 2017
Sex
Female
Sole proprietor
Yes

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
L-10364NMMDLactation Consultant (Non-RN)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X L-10364 NM Yes

Addresses

Primary practice location

30 McLaughlin LN
Sandia Park, NM 87047-6802

Mailing address

30 McLaughlin LN
Sandia Park, NM 87047-6802
Phone (505) 306-1091

Other providers in Sandia Park, NM

All providers in Sandia Park, NM · Lactation Consultant (Non-RN) in New Mexico

Sources for this page

Verify at the official NPI Registry.