Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L166093 | NE |
NPI | 1275164006 |
---|---|
Provider Name | Miriam Heider |
First Address | Lincoln, NE 68516-3653 |
Second Address | Lincoln, NE 68516-3653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2020 |
Last Update Date | 30/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
L166093 | LACTATION (01) | NE |