Provider Demographics
NPI:1851740880
Name:STAPLETON, ELIZABETH (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:STAPLETON
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 1:2891 RICHMOND RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1720
Mailing Address - Country:US
Mailing Address - Phone:859-335-5949
Mailing Address - Fax:
Practice Address - Street 1:2891 RICHMOND RD
Practice Address - Street 2:SUITE 103
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1720
Practice Address - Country:US
Practice Address - Phone:859-335-5949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1100700163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant