Provider Demographics
NPI:1669195970
Name:FROST, ELISABETH (RN-BSN, IBCLC)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:FROST
Suffix:
Gender:F
Credentials:RN-BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 FARMER LN
Mailing Address - Street 2:
Mailing Address - City:JARRELL
Mailing Address - State:TX
Mailing Address - Zip Code:76537-1900
Mailing Address - Country:US
Mailing Address - Phone:512-688-7457
Mailing Address - Fax:
Practice Address - Street 1:124 FARMER LN
Practice Address - Street 2:
Practice Address - City:JARRELL
Practice Address - State:TX
Practice Address - Zip Code:76537-1900
Practice Address - Country:US
Practice Address - Phone:512-688-7457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX856821163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty