Provider Demographics
NPI:1437983194
Name:RITCHART, JESSICA (IBCLC)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:RITCHART
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N6247 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW LISBON
Mailing Address - State:WI
Mailing Address - Zip Code:53950-9454
Mailing Address - Country:US
Mailing Address - Phone:608-547-9314
Mailing Address - Fax:
Practice Address - Street 1:N6247 12TH AVE
Practice Address - Street 2:
Practice Address - City:NEW LISBON
Practice Address - State:WI
Practice Address - Zip Code:53950-9454
Practice Address - Country:US
Practice Address - Phone:608-547-9314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIL-166315163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty