Provider Demographics
NPI:1487163341
Name:AYERS, KIANA PATRICE (LACTATION CONSULTANT)
Entity type:Individual
Prefix:
First Name:KIANA
Middle Name:PATRICE
Last Name:AYERS
Suffix:
Gender:F
Credentials:LACTATION CONSULTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 MOUNT ZION RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-3313
Mailing Address - Country:US
Mailing Address - Phone:678-815-6201
Mailing Address - Fax:678-846-5039
Practice Address - Street 1:1740 WINDING WOODS LN
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-3300
Practice Address - Country:US
Practice Address - Phone:678-815-6201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-23
Last Update Date:2017-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN156524163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant