Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-301263 | GA |
NPI | 1134889488 |
---|---|
Provider Name | Karen Madison Mawson |
First Address | Fayetteville, NC 28301-3354 |
Second Address | Fayetteville, NC 28301-2300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2021 |
Last Update Date | 28/12/2021 |