Provider Demographics
NPI:1013374230
Name:LAFFERTY, CYNTHIA (RN,BS,IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:
Last Name:LAFFERTY
Suffix:
Gender:F
Credentials:RN,BS,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21120 E STIRRUP ST
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6524
Mailing Address - Country:US
Mailing Address - Phone:717-991-5306
Mailing Address - Fax:
Practice Address - Street 1:21120 E STIRRUP ST
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-6524
Practice Address - Country:US
Practice Address - Phone:717-991-5306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA11145322174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN