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NPI 1851723878

NPI 1851723878 : AMANDA BLAKENEY BALL RN IBCLC : DENVER, CO

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General NPI Number Information
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    NPI Number           |    1851723878
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    Entity Type          |    Individual 
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    Provider Name        |    AMANDA BLAKENEY BALL RN IBCLC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/01/2013
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    Last Update Date     |    08/01/2013
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Provider Practice Location Address
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    Address Line         |    2703 CLINTON WAY 
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    City                 |    DENVER
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    State                |    CO
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    Zip                  |    80238-2903
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    Country              |    US
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    Telephone            |    303-330-4422
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2703 CLINTON WAY 
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    City                 |    DENVER
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    State                |    CO
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    Zip                  |    80238-2903
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    Country              |    US
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    Telephone            |    303-330-4422
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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        |    163W00000X
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    Taxonomy Name        |    Registered Nurse
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    License Number       |    0176537
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    License Number State |    CO
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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       |    IBCLC 11194957
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    License Number State |    CO
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