Provider Demographics
NPI:1053296715
Name:FOLK, JESSICA LEE (RT (R) (MR) IBCLC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEE
Last Name:FOLK
Suffix:
Gender:F
Credentials:RT (R) (MR) IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9395 SPRING BROOK DR
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:PA
Mailing Address - Zip Code:18013-4255
Mailing Address - Country:US
Mailing Address - Phone:610-568-8831
Mailing Address - Fax:
Practice Address - Street 1:9395 SPRING BROOK DR
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:PA
Practice Address - Zip Code:18013-4255
Practice Address - Country:US
Practice Address - Phone:610-568-8831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAL-316595163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant