Healthcare Provider Details

I. General information

NPI: 1821687617
Provider Name (Legal Business Name): EXPRESSION LACTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2021
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 MEADOW RIDGE DR
ELK CITY OK
73644-9732
US

IV. Provider business mailing address

PO BOX 65
CANUTE OK
73626-0065
US

V. Phone/Fax

Practice location:
  • Phone: 580-246-4314
  • Fax:
Mailing address:
  • Phone: 580-246-4314
  • Fax: 580-297-9775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KELSEY SCHONES
Title or Position: OWNER
Credential: APRN, IBCLC
Phone: 580-246-4314