Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 11240270 | OR |
NPI | 1255768925 |
---|---|
Provider Name | Mrs. Kirsten Whitlow Stock |
First Address | Eugene, OR 97404-1992 |
Second Address | Eugene, OR 97404-1992 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2013 |
Last Update Date | 26/09/2013 |