Jennifer Pettus
Lactation Consultant, Non-RN in Folsom, CA. Individual provider (NPI-1).
NPI number1962036020
StatusActive
Last updated in NPPESFeb 27, 2020
Details
- NPI
- 1962036020
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Pettus
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 27, 2020
- Certification date
- Feb 27, 2020
- Last updated
- Feb 27, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174N00000X | Lactation Consultant, Non-RN | – | CA | Yes |
Practice location
1847 Belmar CtFolsom, CA 95630-6142
Phone 916-801-7475
Mailing address
1847 Belmar CtFolsom, CA 95630-6142
Phone 916-801-7475
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