Individual
JENNIFER DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N., IBCLC
Contact information
Practice address
12 PROSPECT AVE, RANDOLPH, VT 05060-1359
(802) 728-4105
Mailing address
12 PROSPECT AVE, RANDOLPH, VT 05060-1359
(802) 728-4105
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
026.0025071
VT
163WL0100X
Lactation Consultant (Registered Nurse)
069122-21
NH
Other
Enumeration date
04/28/2014
Last updated
04/28/2014
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