Individual
STACY CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
4320 SEMINARY RD, ALEXANDRIA, VA 22304-1535
(703) 504-7867
Mailing address
4924 25TH ST S, ARLINGTON, VA 22206-1051
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
R174110
MD
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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