Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1033790472 |
---|---|
Provider Name | Ellenie Marie Cruz |
First Address | New Orleans, LA 70124-3001 |
Second Address | New Orleans, LA 70124-3001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2021 |
Last Update Date | 17/04/2021 |