Organization
ADVANCED BREASTFEEDING SUPPORT OF LAS VEGAS
Active
Other names
AUTUMN WAKE, RN, BSN, IBCLC
Organization subpart
No
Provider details
NPI number
Authorized official
AUTUMN WAKE RN, BSN, IBCLC (OWNER/PRACTITIONER)
(702) 764-9290
Entity
Organization
Contact information
Practice address
6970 S CIMARRON RD STE 100, LAS VEGAS, NV 89113-2135
(702) 764-9290
(702) 473-5383
Mailing address
6970 S CIMARRON RD STE 100, LAS VEGAS, NV 89113-2135
(702) 764-9290
(702) 473-5383
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
—
—
Other
Enumeration date
03/19/2019
Last updated
03/20/2019
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