Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 11172571 | MO |
NPI | 1356698963 |
---|---|
Provider Name | Sharon Kay Demoss |
First Address | Kansas City, MO 64155-2233 |
Second Address | Kansas City, MO 64155-2233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2012 |
Last Update Date | 14/08/2012 |