Individual
STACIE BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
1220 DANZANTE DR SE, RIO RANCHO, NM 87124-8856
(916) 847-0789
Mailing address
1220 DANZANTE DR SE, RIO RANCHO, NM 87124-8856
(916) 847-0789
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-136065
—
174N00000X
Lactation Consultant (Non-RN)
—
—
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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