Individual
MS. DIANE LOUISE BENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, RN, IBCLC, RLC
Contact information
Practice address
1925 TULIP LN, MUNSTER, IN 46321-3241
(317) 726-0668
Mailing address
1925 TULIP LN, MUNSTER, IN 46321-3241
(317) 726-0668
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
28104921
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041409047
REGISTERED NURSE LICENSE
IL
01
—
28104921A
REGISTERED NURSE LICENSE
IN
01
—
L-13475
INTERNATIONAL LACTATION CERTIFICATION ASSOCIATION
—
Enumeration date
08/07/2020
Last updated
08/07/2020
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