Individual
MRS. KACIE RENEE LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
3400 S DOUGLAS BLVD STE 200, OKLAHOMA CITY, OK 73150-1017
(405) 272-7000
Mailing address
1000 N LEE AVE, OKLAHOMA CITY, OK 73102-1080
(405) 272-6207
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
L-304019
OK
363LF0000X
Family Nurse Practitioner
Primary
220428
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220428
APRN-CNP
OK
01
—
L-304019
IBCLC
OK
Enumeration date
07/27/2021
Last updated
10/10/2024
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