Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1346785599 |
---|---|
Provider Name | Laura Page |
First Address | Minneapolis, MN 55411-2355 |
Second Address | Minneapolis, MN 55411-2355 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2016 |
Last Update Date | 26/12/2016 |