Jessica Edmonds, CLC
Individual provider Active NPI Lactation Consultant (Non-RN) · Menands, NY
NPI 1710554175 · NPPES record last updated Jun 4, 2021
Key facts
- NPI
- 1710554175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Lactation Consultant (Non-RN) 174N00000X
- License
- 330912 (MA)
- Practice address
- 1 Dennin Dr
Menands, NY 12204-1203 - Phone
- (518) 992-6105
- NPI assigned
- Jun 4, 2021
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 330912 | MA | MD | Lactation Consultant (Non-RN) |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | 330912 | MA | Yes |
Addresses
Primary practice location
1 Dennin Dr
Menands, NY 12204-1203
Mailing address
1 Dennin Dr
Menands, NY 12204-1203
Other providers in Menands, NY
- Heather Dacus
- Ashley Marie Derosa
- Kaitlin Ann Di Nardo
- Michelle Dillon
- Logan Dodd
- Esquire Drug Inc.
- Rebecca M Fay
- Roman Flis
- Sydney E Foley
- Taneisha Nicole Foy
All providers in Menands, NY · Lactation Consultant (Non-RN) in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2021. 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.