MEDICARE: KIRAN J HAHN 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)	721254	TX

General Provider Information

NPI Number	:	1891129870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRAN J HAHN RN, IBCLC

Provider Business Mailing Address
First Line	:	4301 BAMFORD DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-1205
Country	:	US
Telephone Number	:	512-730-1540
Fax Number	:

Provider Business Practice Location Address
First Line	:	925 WESTBANK DR
Second Line	:	SUITE 100
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-6623
Country	:	US
Telephone Number	:	512-730-1540
Fax Number	:

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

Provider Enumeration Date	:	08/27/2013
Last Update Date	:	08/27/2013

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