Deborah Stafford

Individual provider Active NPI Lactation Consultant (Registered Nurse) · Vado, NM

NPI 1982253902 · NPPES record last updated Sep 11, 2019

Key facts

NPI
1982253902
Entity type
Individual (NPI type 1)
Primary specialty
Lactation Consultant (Registered Nurse) 163WL0100X
License
439550 (NM)
Practice address
220 Vista del Rey Dr
Vado, NM 88072-7236
Phone
(575) 233-3240
NPI assigned
Sep 11, 2019
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
439550NMMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Lactation Consutant on the Go LLC Lactation Consultant Current
since Jan 19, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 439550 NM Yes

Addresses

Primary practice location

220 Vista del Rey Dr
Vado, NM 88072-7236

Mailing address

220 Vista del Rey Dr
Vado, NM 88072-7236
Phone (575) 233-3240

Other providers in Vado, NM

All providers in Vado, NM · Lactation Consultant (Registered Nurse) in New Mexico

Sources for this page

Verify at the official NPI Registry.