MEDICARE: MARILYN KAY POSTON RN, IBCLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WL0100X	Lactation Consultant (Registered Nurse)	L-31689	LA

General Provider Information

NPI Number	:	1003352006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARILYN KAY POSTON RN, IBCLC

Provider Business Mailing Address
First Line	:	1060 GOOD HOPE RD
Second Line	:
City	:	ANACOCO
State	:	LA
Zip	:	71403-2216
Country	:	US
Telephone Number	:	318-452-9324
Fax Number	:

Provider Business Practice Location Address
First Line	:	919 S 10TH ST
Second Line	:
City	:	LEESVILLE
State	:	LA
Zip	:	71446-4613
Country	:	US
Telephone Number	:	318-452-9324
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2017
Last Update Date	:	01/18/2017

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