Individual
MRS. JESSICA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
3300 RIVERMONT AVE, LYNCHBURG, VA 24503-2030
(434) 200-5457
Mailing address
1901 TATE SPRINGS RD, LYNCHBURG, VA 24501-1109
(434) 200-5457
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-49420
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001167682
RN
VA
01
—
L-49420
LACTATION CONSULTANT (IBCLC)
VA
Enumeration date
09/18/2015
Last updated
09/18/2015
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