Provider Demographics
NPI:1649035411
Name:STANLEY, LAUREN POU (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:POU
Last Name:STANLEY
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:STANLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAUREN POU STANLEY
Mailing Address - Street 1:10140 THORNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-7628
Mailing Address - Country:US
Mailing Address - Phone:318-393-9479
Mailing Address - Fax:
Practice Address - Street 1:910 PIERREMONT RD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-2069
Practice Address - Country:US
Practice Address - Phone:318-515-2286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA223714163WL0100X
LAL-310996163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant