Individual
LAURA L KELSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN, IBCLC
Contact information
Practice address
65 BUGGER HOLLOW RD, FAYETTEVILLE, TN 37334-6863
(320) 703-8214
Mailing address
65 BUGGER HOLLOW RD, FAYETTEVILLE, TN 37334-6863
(320) 703-8214
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
250884
TN
163WM0102X
Maternal Newborn Registered Nurse
250884
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L-313960
IBCLC
—
Enumeration date
08/09/2024
Last updated
08/09/2024
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