Individual
NASTASSIA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, IBCLC
Contact information
Practice address
36 RANDOLPH PL, WEST ORANGE, NJ 07052-4808
(914) 882-9475
(973) 860-2220
Mailing address
191 CENTRAL AVE STE 213, NEWARK, NJ 07103-3921
(973) 488-7975
(973) 860-2220
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
26NR15908000
NJ
163WL0100X
Lactation Consultant (Registered Nurse)
558884
NY
Other
Enumeration date
04/21/2016
Last updated
04/20/2019
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