KELLY SORENSEN (NPI# 1629513940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629513940 |
| Entity Type | Individual |
| Full Name | KELLY SORENSEN |
| Credential | IBCLC |
| Practice Address |
23582 Rapalla Ct Athol ID 83801-7002 |
| Practice Telephone | 9095532113 |
| Mailing Telephone | 9095532113 |
| Enumeration Date | 2016-12-21 |
| Last Update Date | 2016-12-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174N00000X | Lactation Consultant, Non-RN | L-110382 | ID | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447758172 | Kelly Sorensen | Counselor | 71 Us Route 1 Ste H, Scarborough, ME 04074-7174 | 2018-01-29 |
| Street Address |
23582 RAPALLA CT |
| City | ATHOL |
| State | ID |
| Zip Code | 83801-7002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366510752 | Christopher Ray Sundquist | Physician Assistant | 6101 W Hwy 54, Suite A, Athol, ID 83801 | 2006-12-01 |
| 1053496869 | Connie Jean Stone | Massage Therapist | 6115 E Hwy 54, Athol, ID 83801 | 2006-10-27 |
| 1659568871 | Carrie Valentine Blake | Midwife | 3155 Gwenn Ct, Athol, ID 83801-4909 | 2007-10-02 |
| 1952673204 | Donald K Merkeley | Pathology | 16301 E Bunco Rd, Athol, ID 83801-5048 | 2012-02-02 |
| 1366982316 | Davina Gelardi | Massage Therapist | 6101 E Highway 54, Athol, ID 83801-6085 | 2017-02-24 |
| 1578956637 | Country Clinical Massage | Massage Therapist | 6101 E Highway 54 Ste A, Athol, ID 83801-6085 | 2015-03-13 |
| 1720390347 | Charla-jo Olorenshaw Spradlin | Physical Therapist | 26453 N Old Highway 95, Athol, ID 83801-7076 | 2010-07-12 |
| 1174783724 | Tamara Marie Barnhart | Chiropractor | 6101 E Highway 54, Unit A, Athol, ID 83801-8255 | 2008-06-16 |
| 1932392933 | Timberlake Family Medicine | Clinic/Center | 6101 E Highway 54 Ste A, Athol, ID 83801-8255 | 2007-08-22 |
| 1861632028 | Natural Health Chiropractic LLC | Clinic/Center | 6101 E Highway 54, Unit A, Athol, ID 83801-8255 | 2009-03-02 |
| Find all providers in zip 83801 | ||||
| Taxonomy Code | 174N00000X |
| Grouping | Other Service Providers |
| Classification | Lactation Consultant, Non-RN |
| An individual trained to provide breastfeeding assistance services to both mothers and infants. Lactation Consultants are not required to be nurses and are trained through specific courses of education. The Lactation Consultant may have additional certification through a national or international organization. |
| Notes: Source: National Uniform Claim Committee [1/1/2011: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205314606 | Melanie Henstrom | Lactation Consultant, Non-RN | 6689 E Playwright Dr, Boise, ID 83716-5831 | 2018-07-30 |
| 1710419676 | Nicole Chamberlain | Lactation Consultant, Non-RN | 1214 Alder St, Sandpoint, ID 83864-1871 | 2017-03-30 |
| 1801253653 | Jennifer C Mcintosh | Lactation Consultant, Non-RN | 16515 N Rimrock Rd, Hayden, ID 83835-7854 | 2016-01-25 |
| 1699017764 | Amy S Peterson | Lactation Consultant, Non-RN | 805 4th Ave Dr, Jerome, ID 83338-2104 | 2013-03-26 |
| 1619591054 | Lynnelle King | Lactation Consultant, Non-RN | 457 S Fitness Pl, Eagle, ID 83616-6568 | 2020-06-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.