Camille Jorgensen, IBCLC

Individual provider Active NPI Lactation Consultant (Non-RN) · Mapleton, UT

NPI 1306661087 · NPPES record last updated Jul 17, 2026

Key facts

NPI
1306661087
Entity type
Individual (NPI type 1)
Primary specialty
Lactation Consultant (Non-RN) 174N00000X
License
L-314354
Practice address
4873 S Poplar Way # B201
Mapleton, UT 84664-5085
Phone
(425) 528-6595
NPI assigned
Nov 18, 2024
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Lay Midwife 175M00000X UT
Lactation Consultant (Non-RN) 174N00000X L-314354 Yes

Addresses

Primary practice location

4873 S Poplar Way # B201
Mapleton, UT 84664-5085

Mailing address

4873 S Poplar Way # B201
Mapleton, UT 84664-5085
Phone (425) 528-6595

Other providers in Mapleton, UT

All providers in Mapleton, UT · Lactation Consultant (Non-RN) in Utah

Sources for this page

Verify at the official NPI Registry.