Provider Demographics
NPI:1952644155
Name:BYRD, ALICE M
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:M
Last Name:BYRD
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ALICE
Other - Middle Name:M
Other - Last Name:BYRD-HANNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, IBCLC, ANLC
Mailing Address - Street 1:404 CREEK POINT LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-3330
Mailing Address - Country:US
Mailing Address - Phone:682-465-1133
Mailing Address - Fax:817-394-0588
Practice Address - Street 1:404 CREEK POINT LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-3330
Practice Address - Country:US
Practice Address - Phone:682-465-1133
Practice Address - Fax:817-394-0588
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX659030163W00000X, 163WM0102X
TX108-57222163WL0100X
174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No174H00000XOther Service ProvidersHealth Educator