Healthcare Provider Details

I. General information

NPI: 1861815631
Provider Name (Legal Business Name): CHRISTIE LEE ROWLAND BCN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 11/02/2021
Certification Date: 11/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 ROSEBUD CIRCLE
ANDALE KS
67001
US

IV. Provider business mailing address

410 ROSEBUD CIRCLE
ANDALE KS
67001
US

V. Phone/Fax

Practice location:
  • Phone: 316-789-4504
  • Fax:
Mailing address:
  • Phone: 316-789-4504
  • Fax: 316-660-7510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number62732
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number62732
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: