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General NPI Number Information
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NPI Number | 1629406194
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Entity Type | Organization
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Legal Business Name | MODERN BEGINNINGS, LLC
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Dates
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Enumeration Date | 10/21/2013
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Last Update Date | 02/03/2014
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Provider Practice Location Address
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Address Line | 2700 TIBBETS DR STE 502
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City | BEDFORD
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State | TX
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Zip | 76022-5916
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Country | US
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Telephone | 817-805-5843
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 TIBBETS DR STE 502
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City | BEDFORD
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State | TX
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Zip | 76022-5916
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Country | US
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Telephone | 817-805-5843
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | JAYNA BAILEY
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Credential | RN, IBCLC
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Telephone | 817-805-5843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State |
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Taxonomy #2
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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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