MEDICARE: OMAIRA HANIF BS, BSN, RN, IBCLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WL0100X	Lactation Consultant (Registered Nurse)	L-302494	TX

General Provider Information

NPI Number	:	1184387912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OMAIRA HANIF BS, BSN, RN, IBCLC

Provider Business Mailing Address
First Line	:	8701 EVELINA TRL
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78737-8541
Country	:	US
Telephone Number	:	520-954-8203
Fax Number	:

Provider Business Practice Location Address
First Line	:	8701 EVELINA TRL
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78737-8541
Country	:	US
Telephone Number	:	520-954-8203
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2021
Last Update Date	:	10/13/2024

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