Individual
MS. LAURA ELIZABETH EMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM, IBCLC
Contact information
Practice address
11206 KENILWORTH AVENUE, GARRETT PARK, MD 20896
(617) 922-5917
Mailing address
PO BOX 53, GARRETT PARK, MD 20896
(617) 922-5917
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-89049
MD
367A00000X
Advanced Practice Midwife
RN1016029
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0700622
—
MA
01
—
2934898
CIGNA
MA
01
—
AA12919
HPHC
MA
01
—
HV0305
BCBS
MA
Enumeration date
01/12/2007
Last updated
03/21/2017
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