Provider Demographics
NPI:1356163117
Name:MARLEY, JANINE (RNC, IBCLC)
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:MARLEY
Suffix:
Gender:F
Credentials:RNC, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3216
Mailing Address - Country:US
Mailing Address - Phone:862-300-6829
Mailing Address - Fax:
Practice Address - Street 1:104 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3216
Practice Address - Country:US
Practice Address - Phone:862-300-6829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR08517600163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant