Jayme Nicole Bolander

Individual provider Active NPI Lactation Consultant (Registered Nurse) · Estero, FL

NPI 1528772555 · NPPES record last updated Jan 13, 2023

Key facts

NPI
1528772555
Entity type
Individual (NPI type 1)
Primary specialty
Lactation Consultant (Registered Nurse) 163WL0100X
License
L-309105 (FL)
Practice address
10600 Chevrolet Way Ste 10517473
Estero, FL 33928-4421
Phone
(813) 291-4695
NPI assigned
Jan 13, 2023
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
L-309105FLMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Lactation Center Lactation Consultant Current
since Jan 15, 2023
Accepting new patients

Locations

10600 Chevrolet Way
Ste 105
Estero, FL 33928
Phone (772) 260-4224

10600 Chevrolet Way
Ste 10517473
Estero, FL 33928

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse)
Group: 193400000X SINGLE SPECIALTY GROUP
163WL0100X L-309105 FL Yes

Addresses

Primary practice location

10600 Chevrolet Way Ste 10517473
Estero, FL 33928-4421

Mailing address

17473 Ashcomb Way
Estero, FL 33928-6517
Phone (813) 291-4695

Other identifiers

IdentifierTypeStateIssuer
NONEOtherNONE

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL thrivelactationcenter.com Direct

Other providers in Estero, FL

All providers in Estero, FL · Lactation Consultant (Registered Nurse) in Florida

Sources for this page

Verify at the official NPI Registry.