Audra Burton-Easterbrook, RAN, IBCLC

Individual provider Active NPI Lactation Consultant (Registered Nurse) · West Milford, NJ

NPI 1184095085 · NPPES record last updated Oct 18, 2015

Key facts

NPI
1184095085
Entity type
Individual (NPI type 1)
Primary specialty
Lactation Consultant (Registered Nurse) 163WL0100X
License
L-13659 (NJ)
Practice address
34 Algonquin Way
West Milford, NJ 07480-4102
Phone
(973) 650-9828
NPI assigned
Oct 18, 2015
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

State licenses

LicenseStateTypeSpecialty
26NO12394800NJMDLactation Consultant (Registered Nurse)
L-13659NJMDLactation Consultant (Registered Nurse)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 26NO12394800 NJ
Lactation Consultant (Registered Nurse) 163WL0100X L-13659 NJ Yes

Addresses

Primary practice location

34 Algonquin Way
West Milford, NJ 07480-4102

Mailing address

34 Algonquin Way
West Milford, NJ 07480-4102
Phone (973) 650-9828

Other providers in West Milford, NJ

All providers in West Milford, NJ · Lactation Consultant (Registered Nurse) in New Jersey

Sources for this page

Verify at the official NPI Registry.