Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1366077992 |
---|---|
Provider Name | Nicole Christine Brown |
First Address | Simi Valley, CA 93063-4736 |
Second Address | Simi Valley, CA 93063-4736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2020 |
Last Update Date | 04/03/2020 |