Provider Demographics
NPI:1841780566
Name:TLC FAMILY WELLNESS PLLC
Entity Type:Organization
Organization Name:TLC FAMILY WELLNESS PLLC
Other - Org Name:TLC LACTATION CONSULTING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER, PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:775-771-1390
Mailing Address - Street 1:1001 PYRAMID WAY STE 206
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-4470
Mailing Address - Country:US
Mailing Address - Phone:775-799-8188
Mailing Address - Fax:602-354-9272
Practice Address - Street 1:1001 PYRAMID WAY STE 206
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-4470
Practice Address - Country:US
Practice Address - Phone:775-799-8188
Practice Address - Fax:602-354-9272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-17
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV250030289Medicaid