Organization
HAMPTON ROADS LACTATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER TOBOLA RN, IBCLC (LACTATION CONSULTANT)
(757) 598-4818
Entity
Organization
Contact information
Practice address
5106 W CREEK CT, SUFFOLK, VA 23435-3523
(757) 598-4818
(757) 610-9395
Mailing address
5106 W CREEK CT, SUFFOLK, VA 23435-3523
(757) 598-4818
(757) 610-9395
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
1257572
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841708211
NPI 1
VA
Enumeration date
03/25/2018
Last updated
06/11/2019
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