Suzanne Nunnally, BSN, RN, IBCLC, RLC

Individual provider Active NPI Lactation Consultant (Registered Nurse) · Pendergrass, GA

NPI 1336863232 · NPPES record last updated Oct 4, 2022

Key facts

NPI
1336863232
Entity type
Individual (NPI type 1)
Primary specialty
Lactation Consultant (Registered Nurse) 163WL0100X
License
L-33226 (GA)
Practice address
84 Kinney Creek LN
Pendergrass, GA 30567-2281
Phone
(678) 617-0640
NPI assigned
Oct 4, 2022
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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
L-33226GAMDLactation Consultant (Registered Nurse)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X L-33226 GA Yes

Addresses

Primary practice location

84 Kinney Creek LN
Pendergrass, GA 30567-2281

Mailing address

84 Kinney Creek LN
Pendergrass, GA 30567-2281

Other providers in Pendergrass, GA

All providers in Pendergrass, GA · Lactation Consultant (Registered Nurse) in Georgia

Sources for this page

Verify at the official NPI Registry.