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General NPI Number Information
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NPI Number | 1548084288
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Entity Type | Organization
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Legal Business Name | GOOD LIFE LACTATION LLC
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/11/2024
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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 | 402-690-1689
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Fax |
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Provider Business Mailing Address
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Address Line | 6614 GOODE DR
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City | SHAWNEE
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State | KS
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Zip | 66216-2515
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Country | US
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Telephone | 913-662-3415
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/LACTATION CONSULTANT
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Name | NATASHA KAY MIZNER
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Credential | RN, BSN, IBCLC
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Telephone | 402-690-1689
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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 |
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License Number State |
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