PROFESSIONAL BREASTFEEDING SUPPORT LLC (NPI# 1902266919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902266919 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL BREASTFEEDING SUPPORT LLC |
| Practice Address |
4630 W Walton Blvd Waterford MI 48329-3535 |
| Practice Telephone | 2487951984 |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2016-03-03 |
| Authorized Official Name | MS. PAMELA ANZICEK (OWNER/IBCLC) |
| Authorized Official Telephone | 2487951984 |
| Authorized Official Credential | RN IBCLC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers | ||
| N | 174N00000X | Lactation Consultant, Non-RN | Other Service Providers | ||
| Y | 163WL0100X |
Registered Nurse Specialization: Lactation Consultant |
Nursing Service Providers |
| Street Address |
4630 W WALTON BLVD |
| City | WATERFORD |
| State | MI |
| Zip Code | 48329-3535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386124139 | Melissa A Blake | Occupational Therapist | 3257 Whitfield Ct, Waterford, MI 48329 | 2018-08-20 |
| 1932699741 | Julianne Marie Fittonneville | Counselor | 4000 W Walton Blvd Ste A&b, Waterford, MI 48329 | 2018-05-16 |
| 1730615717 | Innovative Lifestyles, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5490 Dixie Hwy, Suite 1, Waterford, MI 48329 | 2017-05-11 |
| 1841670502 | Kayla Brianne Dandino | Speech-Language Pathologist | 5601 Hatchery Rd., Waterford Township, MI 48329 | 2015-06-08 |
| 1093122400 | Caring 4 Loved Ones, Inc | Registered Nurse | 3549 Lakeshore Dr., Waterford, MI 48329 | 2014-07-17 |
| 1124448329 | Michael Alan Watson | Emergency Medicine | 5826 Dixie Hwy, Waterford Township, MI 48329 | 2014-04-27 |
| 1417263120 | Metro Imaging Center Plc | Dentist | 4664 W. Walton Blvd., Waterford, MI 48329 | 2010-08-19 |
| 1225278013 | S.e.t. Footcare, P.C. | Podiatrist | 4396-1 Dixie Hwy, Waterford, MI 48329 | 2009-03-06 |
| 1962556498 | Mark Andrew Laszlo | Dentist | 4624 Walton Blvd, Waterford, MI 48329 | 2007-01-22 |
| 1437211927 | Pankajini N Doshi | Pediatrics | 4299 Roseberry Ct, Waterford, MI 48329 | 2006-12-14 |
| Find all providers in zip 48329 | ||||
| Taxonomy Code | 163WL0100X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Lactation Consultant |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851183 | Cynthia Jean Werner | Registered Nurse | 70067 Beach Dr, Edwardsburg, MI 49112-8434 | 2020-11-07 |
| 1790392959 | Theresa Hope Madoun | Registered Nurse | 3362 Parkland Dr, West Bloomfield, MI 48322-1828 | 2020-09-30 |
| 1609491133 | Rebecca Shanahan | Registered Nurse | 3489 W River Rd, Muskegon, MI 49445-9606 | 2020-06-10 |
| 1841814456 | Tara Roberta Sullivan | Registered Nurse | 24808 Boston St, Dearborn, MI 48124-4411 | 2020-05-31 |
| 1861031957 | Rebecca Taylor | Registered Nurse | 3150 Livernois Rd Ste 175, Troy, MI 48083-5058 | 2020-01-06 |
| 1275174484 | Micia Jena Eddins | Registered Nurse | 4217 Aretha Ave, Detroit, MI 48201-1556 | 2019-09-30 |
| 1790248854 | Lactation Home Support LLC | Registered Nurse | 1218 S Forest Dr, Muskegon, MI 49442-4814 | 2019-04-07 |
| 1386119477 | Lisa Marie Levy | Registered Nurse | 520 N Silvery Ln, Dearborn, MI 48128-1538 | 2018-10-04 |
| 1932680717 | Barbara Danielle Demske | Registered Nurse | 269 Roland St, Belleville, MI 48111-2742 | 2018-08-28 |
| 1053800649 | Leontine Wallace | Registered Nurse | 2300 Haggerty Rd Ste 2110, West Bloomfield, MI 48323-2191 | 2018-05-09 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PROFESSIONAL BREASTFEEDING SUPPORT LLC.
| 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.