Healthcare Provider Details

I. General information

NPI: 1447719737
Provider Name (Legal Business Name): SARAH AMY YARBROUGH RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2019
Last Update Date: 03/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2017 BROADWAY ST
PEARLAND TX
77581-5501
US

IV. Provider business mailing address

3231 FONTAINE DR
PEARLAND TX
77584-9058
US

V. Phone/Fax

Practice location:
  • Phone: 281-485-9990
  • Fax:
Mailing address:
  • Phone: 337-794-1220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number880291
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: