Provider Demographics
NPI:1861118515
Name:BUCK, JILL STRICKLAND (RN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:STRICKLAND
Last Name:BUCK
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 1:871 WINDING WOOD DR
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36093-1685
Mailing Address - Country:US
Mailing Address - Phone:334-219-0110
Mailing Address - Fax:
Practice Address - Street 1:871 WINDING WOOD DR
Practice Address - Street 2:
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36093-1685
Practice Address - Country:US
Practice Address - Phone:334-219-0110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-074067163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL01010101OtherLACTATION