Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | ALPP-39863 | TN |
NPI | 1083077572 |
---|---|
Provider Name | Emily Kearney |
First Address | Memphis, TN 38117-7213 |
Second Address | Memphis, TN 38117-7213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2016 |
Last Update Date | 01/04/2016 |