Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 10918138 | AK |
NPI | 1376897926 |
---|---|
Provider Name | Ms. Sarah Rush Stevens |
First Address | Anchorage, AK 99508-5051 |
Second Address | Anchorage, AK 99508-5051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2012 |
Last Update Date | 05/11/2012 |