Balanced Baby Lactation LLC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

Legal business name

BALANCED BABY LACTATION LLC

Practice address

316 Buck TRL
Twin Lakes, WI 53181-9637

Phone

(262) 914-1433

NPI assigned

Apr 8, 2026

Last updated

Apr 8, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jenell Diane Jackley, CPNP IBCLCNPI 1942502612

Title

Owner

Phone

(262) 914-1433

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jenell Diane Jackley, CPNP

  • Pediatric Nurse Practitioner
  • Kenosha, WI
  • NPI 1942502612

  Pediatrics

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1775606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775606400000",
    "number": "1700728763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 BUCK TRL",
            "city": "TWIN LAKES",
            "state": "WI",
            "postal_code": "531819637",
            "telephone_number": "262-914-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 BUCK TRL",
            "city": "TWIN LAKES",
            "state": "WI",
            "postal_code": "531819637",
            "telephone_number": "262-914-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED BABY LACTATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-08",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A",
        "authorized_official_last_name": "JACKLEY",
        "authorized_official_first_name": "JENELL",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-914-1433",
        "authorized_official_credential": "CPNP IBCLC"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Nurse Practitioner in Twin Lakes, WI
• Providers in Twin Lakes, WI by specialty
• Pediatric Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.