Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-136153 | ME |
N | 176B00000X | Midwife | CPM650 | ME |
NPI | 1063856045 |
---|---|
Provider Name | Mrs. Tiffany Nicole Carter Skillings |
First Address | Yarmouth, ME 04096-7005 |
Second Address | Yarmouth, ME 04096-7005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2013 |
Last Update Date | 11/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
14030014 | NARM ID (01) | ME |
205089 | ALPP ID (01) | ME |
CPM650 | STATE OF MAINE (01) | ME |
L136153 | IBCLC ID (01) |