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General NPI Number Information
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NPI Number | 1104610278
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Entity Type | Individual
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Provider Name | AUDREY LYNN HARRIS RN ADN IBCLC
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Gender | Female
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Dates
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Enumeration Date | 04/05/2025
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Last Update Date | 04/05/2025
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Provider Practice Location Address
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Address Line | 7398 W 162ND TER
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City | OVERLAND PARK
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State | KS
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Zip | 66085-8240
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Country | US
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Telephone | 913-662-3415
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Fax |
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Provider Business Mailing Address
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Address Line | 3309 SW LONGVIEW RD
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City | LEES SUMMIT
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State | MO
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Zip | 64081-2124
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Country | US
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Telephone | 816-289-3629
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | 20060201099
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License Number State | MO
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