Healthcare Provider Details

I. General information

NPI: 1750050613
Provider Name (Legal Business Name): LOLA BABIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2021
Last Update Date: 09/13/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 SOMERSET ST
LAFAYETTE CO
80026-1156
US

IV. Provider business mailing address

1110 SOMERSET ST
LAFAYETTE CO
80026-1156
US

V. Phone/Fax

Practice location:
  • Phone: 970-227-5080
  • Fax:
Mailing address:
  • Phone: 970-227-5080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY DANIELS
Title or Position: CO-OWNER
Credential: PNP, RN, IBCLC
Phone: 970-227-5080