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Organization

CANNAMOMMY.ORG, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KELLY USBORNE BRUCE (EXECUTIVE DIRECTOR)
(970) 471-9241
Entity
Organization

Contact information

Practice address
824 CRISSY WAY, FORTUNA, CA 95540-3152
(970) 471-9241
Mailing address
824 CRISSY WAY, FORTUNA, CA 95540-3152
(970) 471-9241

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
163WL0100X
Lactation Consultant (Registered Nurse)
163WM0102X
Maternal Newborn Registered Nurse
171400000X
Health & Wellness Coach
176B00000X
Midwife
374J00000X
Doula
Primary

Other

Enumeration date
03/03/2025
Last updated
03/03/2025
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