Individual
KELLIE JO FATEMIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLBC
Contact information
Practice address
1901 N MACARTHUR BLVD, IRVING, TX 75061-2220
(214) 606-5352
Mailing address
11427 PARK CENTRAL PL, DALLAS, TX 75230-3357
(214) 606-5352
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-157278
TX
Other
Enumeration date
11/23/2024
Last updated
11/23/2024
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