Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | FL |
NPI | 1184134769 |
---|---|
Provider Name | Katie Lynn Bankston |
First Address | Tallahassee, FL 32308-4817 |
Second Address | Tallahassee, FL 32308-4817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2017 |
Last Update Date | 09/10/2017 |