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Organization

BALANCED BABY LACTATION LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENELL DIANE JACKLEY CPNP IBCLC (OWNER)
(262) 914-1433
Entity
Organization

Contact information

Practice address
316 BUCK TRL, TWIN LAKES, WI 53181-9637
(262) 914-1433
Mailing address
316 BUCK TRL, TWIN LAKES, WI 53181-9637
(262) 914-1433

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary

Other

Enumeration date
04/08/2026
Last updated
04/08/2026
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