Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | NV |
NPI | 1225494875 |
---|---|
Provider Name | Alexa Rockwell |
First Address | Henderson, NV 89011-2647 |
Second Address | Las Vegas, NV 89123-4824 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2016 |
Last Update Date | 12/01/2016 |