Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1295075265 |
---|---|
Provider Name | Dr. Jennifer Marie Pusins |
First Address | Ft Lauderdale, FL 33329-0370 |
Second Address | Davie, FL 33314-4416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2013 |
Last Update Date | 12/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1030508500001 | (05) | PA |