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General NPI Number Information
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NPI Number | 1841095684
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Entity Type | Individual
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Provider Name | OLIVIA KATHERINE MOREY IBCLC
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Gender | Female
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Dates
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Enumeration Date | 02/17/2025
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 5344 N BROADWAY ST
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City | KNOXVILLE
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State | TN
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Zip | 37918-3266
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Country | US
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Telephone | 865-505-0880
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Fax |
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Provider Business Mailing Address
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Address Line | 112 VINEYARD BLVD
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City | RINGGOLD
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State | GA
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Zip | 30736-4227
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Country | US
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Telephone | 423-364-5090
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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 | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number | L-316693
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License Number State |
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