Individual
ABBY BOELTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN, IBCLC
Contact information
Practice address
1900 CENTRACARE CIR STE 1300, SAINT CLOUD, MN 56303-5000
(320) 654-3610
(320) 654-3647
Mailing address
1900 CENTRACARE CIR STE 1300, SAINT CLOUD, MN 56303-5000
(320) 654-3610
(320) 654-3647
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
L64140-1
MN
174N00000X
Lactation Consultant (Non-RN)
Primary
L-46770
MN
Other
Enumeration date
01/20/2014
Last updated
01/20/2014
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