Healthcare Provider Details

I. General information

NPI: 1033032891
Provider Name (Legal Business Name): EMILY LAURAN HAFER RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 MILLARD FARMER IND BLVD STE A3
NEWNAN GA
30263-5821
US

IV. Provider business mailing address

1798 MINIX RD
SHARPSBURG GA
30277-1693
US

V. Phone/Fax

Practice location:
  • Phone: 678-552-9140
  • Fax:
Mailing address:
  • Phone: 636-222-0149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN61261214
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN61261214
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: