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Individual

KELLI NICOLE BRIEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CD(DONA) LCCE, CLS

Contact information

Practice address
115 E WOODSIDE ST, SOUTH BEND, IN 46614-1113
Mailing address
PO BOX 2648, SOUTH BEND, IN 46680-2648
(574) 383-1743

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
174H00000X
Health Educator
174N00000X
Lactation Consultant (Non-RN)
261QB0400X
Birthing Clinic/Center
261QF0050X
Non-Surgical Family Planning Clinic/Center
261QP0905X
State or Local Public Health Clinic/Center
374J00000X
Doula
Primary
IN

Other

Enumeration date
06/10/2019
Last updated
09/29/2019
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