Provider Demographics
NPI:1619433224
Name:ZAPATA STILES, DANICA JEAN (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:DANICA
Middle Name:JEAN
Last Name:ZAPATA STILES
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:DANICA
Other - Middle Name:JEAN
Other - Last Name:STILES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, IBCLC
Mailing Address - Street 1:1592 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-3901
Mailing Address - Country:US
Mailing Address - Phone:541-221-3388
Mailing Address - Fax:
Practice Address - Street 1:1592 GROVE ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-3901
Practice Address - Country:US
Practice Address - Phone:541-221-3388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL-151868163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty