Provider Demographics
NPI:1497227557
Name:JENKINS, LUCIA (RN, IBCLC)
Entity type:Individual
Prefix:MS
First Name:LUCIA
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 HAWTHORNE ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-3622
Mailing Address - Country:US
Mailing Address - Phone:781-507-1980
Mailing Address - Fax:
Practice Address - Street 1:16 HAWTHORNE ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-3622
Practice Address - Country:US
Practice Address - Phone:781-507-1980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA129458163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant