Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-154706 |
NPI | 1164093480 |
---|---|
Provider Name | Shannon Oakley |
First Address | Rockford, IL 61108-2326 |
Second Address | Eddyville, KY 42038-7952 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2021 |
Last Update Date | 07/07/2021 |