Amy Fetters Jimenez, IBCLC
Lactation Consultant, Non-RN in Niceville, FL. Individual provider (NPI-1).
NPI number1760106652
StatusActive
Last updated in NPPESOct 3, 2022
Details
- NPI
- 1760106652
- Entity type
- Individual (NPI-1)
- Name
- Amy Fetters Jimenez
- Credential
- IBCLC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 3, 2022
- Certification date
- Oct 3, 2022
- Last updated
- Oct 3, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174N00000X | Lactation Consultant, Non-RN | L-100984 | – | Yes |
Practice location
310 Curacao WayNiceville, FL 32578-4079
Phone 910-273-7014
Mailing address
310 Curacao WayNiceville, FL 32578-4079
Phone 910-273-7014
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