Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1194186007 |
---|---|
Provider Name | Janna Palmer |
First Address | Wichita, KS 67207-2845 |
Second Address | Wichita, KS 67207-2845 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2016 |
Last Update Date | 19/03/2016 |