Individual
ALICIA LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
1101 VISTA VIEW LN APT 118, WINSTON SALEM, NC 27103-3136
(336) 486-7661
Mailing address
1101 VISTA VIEW LN APT 118, WINSTON SALEM, NC 27103-3136
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
230556
NC
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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