Provider Demographics
NPI:1407612989
Name:KNERR, LAURYNN (RN IBCLC)
Entity Type:Individual
Prefix:
First Name:LAURYNN
Middle Name:
Last Name:KNERR
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 1:2257 E QUESTA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-5315
Mailing Address - Country:US
Mailing Address - Phone:815-666-6775
Mailing Address - Fax:
Practice Address - Street 1:13802 N 32ND ST STE 8
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-5638
Practice Address - Country:US
Practice Address - Phone:815-666-6775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZL-312475163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant