Individual
SHANNON VANDEVOORDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CLC
Contact information
Practice address
387 W BROADWAY, BOSTON, MA 02127-2217
(857) 496-5095
Mailing address
724 E 2ND ST UNIT 1, BOSTON, MA 02127-2317
(857) 496-5095
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
CLC78333
MA
163WM0102X
Maternal Newborn Registered Nurse
RN2268347
MA
Other
Enumeration date
11/29/2018
Last updated
11/29/2018
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