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General NPI Number Information
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NPI Number | 1750050613
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Entity Type | Organization
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Legal Business Name | LOLA BABIES
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 1110 SOMERSET ST
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City | LAFAYETTE
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State | CO
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Zip | 80026-1156
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Country | US
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Telephone | 970-227-5080
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 SOMERSET ST
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City | LAFAYETTE
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State | CO
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Zip | 80026-1156
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Country | US
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Telephone | 970-227-5080
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | COURTNEY DANIELS
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Credential | PNP, RN, IBCLC
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Telephone | 970-227-5080
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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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