Healthcare Provider Details

I. General information

NPI: 1396498754
Provider Name (Legal Business Name): YOUR FEEDING FRIEND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2022
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4217 ARMSTEAD AVE
EDMOND OK
73012-4819
US

IV. Provider business mailing address

4217 ARMSTEAD AVE
EDMOND OK
73012-4819
US

V. Phone/Fax

Practice location:
  • Phone: 405-261-8220
  • Fax: 405-518-8003
Mailing address:
  • Phone: 405-261-8220
  • Fax: 405-518-8003

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: BRITTANY SANDOVAL
Title or Position: OWNER
Credential: RN, IBCLC
Phone: 505-930-0258