Provider Demographics
NPI:1184417222
Name:SOUTHWEST MINNESOTA LACTATION AND BEYOND, LLC
Entity type:Organization
Organization Name:SOUTHWEST MINNESOTA LACTATION AND BEYOND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNM, IBCLC
Authorized Official - Phone:507-430-0636
Mailing Address - Street 1:425 241ST ST
Mailing Address - Street 2:
Mailing Address - City:BALATON
Mailing Address - State:MN
Mailing Address - Zip Code:56115-1107
Mailing Address - Country:US
Mailing Address - Phone:507-430-0636
Mailing Address - Fax:
Practice Address - Street 1:348 W MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-1371
Practice Address - Country:US
Practice Address - Phone:507-401-2688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty