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Individual

MRS. JESSICA SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
IBCLC

Contact information

Practice address
430 CASALOMA DR, FOREST, VA 24551-1702
(434) 851-8273
(434) 205-9151
Mailing address
430 CASALOMA DR, FOREST, VA 24551-1702
(434) 851-8273
(434) 205-9151

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
06/06/2026
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