Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1154839017 |
---|---|
Provider Name | Connor Anne Giddens |
First Address | Cookeville, TN 38501-4690 |
Second Address | Cookeville, TN 38501-4690 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2018 |
Last Update Date | 28/06/2019 |