Provider Demographics
NPI:1831680420
Name:LORD, KRISTI LYN (RN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:LYN
Last Name:LORD
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 1:5604 S 173RD AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-2238
Mailing Address - Country:US
Mailing Address - Phone:402-926-6321
Mailing Address - Fax:
Practice Address - Street 1:10818 ELM ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4820
Practice Address - Country:US
Practice Address - Phone:402-502-0617
Practice Address - Fax:402-502-4676
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-20
Last Update Date:2018-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEL-134888163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE163WL0100XOtherRN