Jaclyn Keegan
Individual provider Active NPI Lactation Consultant (Registered Nurse) · Pleasant Ridge, MI
NPI 1295558740 · NPPES record last updated Nov 4, 2024
Key facts
- NPI
- 1295558740
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Lactation Consultant (Registered Nurse) 163WL0100X
- License
- 4704308999 (MI)
- Practice address
- 23 Maywood Ave
Pleasant Ridge, MI 48069-1232 - Phone
- (760) 209-4067
- NPI assigned
- Nov 4, 2024
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 4704308999 | MI | MD | Lactation Consultant (Registered Nurse) |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Registered Nurse) | 163WL0100X | 4704308999 | MI | Yes |
Addresses
Primary practice location
23 Maywood Ave
Pleasant Ridge, MI 48069-1232
Mailing address
23 Maywood Ave
Pleasant Ridge, MI 48069-1232
Other providers in Pleasant Ridge, MI
- Atif M George
- Shaye Golden
- Phyllis Hightower
- Michelle Holcombe
- Jessica Jarrard
- Amy Virginia Kuzniar
- Stephanie Laird
- Jonathan Lyskawa
- Metta & Moxie Therapeutics, LLC
- Michigan Glaucoma & Cataract, P.C.
All providers in Pleasant Ridge, MI · Lactation Consultant (Registered Nurse) in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2024. 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.