Provider Demographics
NPI:1174879092
Name:TANELLA, CARI JEAN (RN-IBCLC)
Entity type:Individual
Prefix:MS
First Name:CARI
Middle Name:JEAN
Last Name:TANELLA
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 1:8414 SICILIANO ST
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-7165
Mailing Address - Country:US
Mailing Address - Phone:561-302-3871
Mailing Address - Fax:
Practice Address - Street 1:8414 SICILIANO ST
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-7165
Practice Address - Country:US
Practice Address - Phone:561-302-3871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-29
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN919187163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant