Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1154932838 |
---|---|
Provider Name | Krista Baggett |
First Address | Bradenton, FL 34203-8896 |
Second Address | Bradenton, FL 34203-8896 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2020 |
Last Update Date | 14/08/2020 |