Individual
VANESSA LYNN HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLC, RNFA
Contact information
Practice address
14089 W CHARTER OAK RD, SURPRISE, AZ 85379-5511
(623) 330-3646
Mailing address
14089 W CHARTER OAK RD, SURPRISE, AZ 85379-5511
(623) 330-3646
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
10961014
AZ
163WR0006X
Registered Nurse First Assistant
Primary
RN114974
AZ
Other
Enumeration date
02/01/2012
Last updated
09/14/2017
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