National Provider Identifier Database

MALLORY D MUDD POMERVILLE, IBCLC, LPN – NPI #1174941892
Lactation Consultant


Contact Information

MALLORY D MUDD POMERVILLE, IBCLC, LPN
1538 BOWFIN CT
UNIT D
KEY WEST, FL33040-6725
Phone: 660-909-2350
Fax:
Website:
Specialty Taxonomy Code
* Lactation Consultant 163WL0100X
Licensed Practical Nurse 164W00000X

* Indicates primary specialty

NPI Profile & details for MALLORY D MUDD POMERVILLE

NPI Number 1174941892
Credentials IBCLC, LPN
Entity Individual
Enumeration date 03/31/2014
Last updated 03/31/2014 - About 12 years ago
Sole proprietor1 Yes
Identifiers
  • FL License #: L-41930
  • FL License #: PN 5214349
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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