Provider Demographics
NPI:1558641779
Name:ROMERO, KARMAN ELISE (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:KARMAN
Middle Name:ELISE
Last Name:ROMERO
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 MELODY CT
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060-7646
Mailing Address - Country:US
Mailing Address - Phone:816-500-0862
Mailing Address - Fax:
Practice Address - Street 1:1119 MELODY CT
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:MO
Practice Address - Zip Code:64060-7646
Practice Address - Country:US
Practice Address - Phone:816-500-0862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO108-35129163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant