Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-157122 |
NPI | 1144881848 |
---|---|
Provider Name | Shannon Gill |
First Address | Denver, CO 80209-4107 |
Second Address | Denver, CO 80209-4107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2019 |
Last Update Date | 24/06/2019 |