Provider Demographics
NPI:1043095680
Name:STAFFORD, LAURA KATHRYN (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:KATHRYN
Last Name:STAFFORD
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 KAITLYN CT
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:TX
Mailing Address - Zip Code:76226-1386
Mailing Address - Country:US
Mailing Address - Phone:214-334-0102
Mailing Address - Fax:
Practice Address - Street 1:9000 KAITLYN CT
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:TX
Practice Address - Zip Code:76226-1386
Practice Address - Country:US
Practice Address - Phone:214-334-0102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX789482163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant