Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1063166213 |
---|---|
Provider Name | Cristina Evans |
First Address | North Chesterfield, VA 23235-4870 |
Second Address | North Chesterfield, VA 23235-4870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2022 |
Last Update Date | 07/02/2022 |