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Individual

LEAH NYDAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
IBCLC

Contact information

Practice address
625 E BROADWAY AVE, JACKSON, WY 83001-8642
(307) 739-7572
Mailing address
625 E BROADWAY AVE, JACKSON, WY 83001-8642

Taxonomy

Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-311500
WY

Other

Enumeration date
10/17/2023
Last updated
10/17/2023
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