Provider Demographics
NPI:1720863228
Name:STAMPER, LILIANA AGUILAR (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:LILIANA
Middle Name:AGUILAR
Last Name:STAMPER
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 SHAFFER DR
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46580-4737
Mailing Address - Country:US
Mailing Address - Phone:574-265-6546
Mailing Address - Fax:
Practice Address - Street 1:216 SHAFFER DR
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-4737
Practice Address - Country:US
Practice Address - Phone:574-265-6546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28189313A163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant