MEDICARE: DANIELLE GIVENS RN, BSN, 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-317340	NV

General Provider Information

NPI Number	:	1316756554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE GIVENS RN, BSN, IBCLC

Provider Business Mailing Address
First Line	:	7267 PHLOX RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3225
Country	:	US
Telephone Number	:	601-597-0418
Fax Number	:

Provider Business Practice Location Address
First Line	:	7267 PHLOX RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3225
Country	:	US
Telephone Number	:	601-597-0418
Fax Number	:

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

Provider Enumeration Date	:	01/02/2025
Last Update Date	:	01/02/2025

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