Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-49630 | NE |
NPI | 1174030050 |
---|---|
Provider Name | Mckenzie Ann Jones |
First Address | Omaha, NE 68116-4606 |
Second Address | Omaha, NE 68144-4820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2018 |
Last Update Date | 31/01/2018 |