Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1366054777 |
---|---|
Provider Name | Devon Ragan |
First Address | Conowingo, MD 21918-1325 |
Second Address | Conowingo, MD 21918-1325 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2020 |
Last Update Date | 18/08/2020 |