Provider Demographics
NPI:1942680491
Name:POWERED BY NATURE LLC
Entity Type:Organization
Organization Name:POWERED BY NATURE LLC
Other - Org Name:BLOOM INTO PARENTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:865-582-6585
Mailing Address - Street 1:220 GREEN HILL RD
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37354-6643
Mailing Address - Country:US
Mailing Address - Phone:865-582-6585
Mailing Address - Fax:
Practice Address - Street 1:141 N MARTINWOOD RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-5137
Practice Address - Country:US
Practice Address - Phone:865-582-6585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-30
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL-46463174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty