Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1043732688 |
---|---|
Provider Name | Christi Bednarek |
First Address | Elmwood Park, WI 53405-4533 |
Second Address | Elmwood Park, WI 53405-4533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2017 |
Last Update Date | 14/07/2017 |