Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-104791 |
NPI | 1316699044 |
---|---|
Provider Name | Kristin Ann Conley |
First Address | Westminster, CO 80234-2773 |
Second Address | Denver, CO 80211-3827 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2022 |
Last Update Date | 24/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
L-104791 | INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS (01) |