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Individual

JESSICA RAE TANGEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
IBCLC

Contact information

Practice address
449 OVERLOOK PASS, HUDSON, WI 54016-7547
(320) 221-0443
Mailing address
449 OVERLOOK PASS, HUDSON, WI 54016-7547
(320) 221-0443

Taxonomy

Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-49688

Other

Enumeration date
03/08/2017
Last updated
03/08/2017
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