Provider Demographics
NPI:1144919374
Name:MILKMAID MARION LLC
Entity type:Organization
Organization Name:MILKMAID MARION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:SPRINGER
Authorized Official - Last Name:MARION
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC
Authorized Official - Phone:202-674-9894
Mailing Address - Street 1:1150 E GRANDVIEW RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-2661
Mailing Address - Country:US
Mailing Address - Phone:602-603-4360
Mailing Address - Fax:602-902-9163
Practice Address - Street 1:1150 E GRANDVIEW RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-2661
Practice Address - Country:US
Practice Address - Phone:602-603-4360
Practice Address - Fax:602-902-9163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty