MEDICARE: MARJORIE M BARR R. N., I.B.C.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WL0100X	Lactation Consultant (Registered Nurse)	448769	CA

General Provider Information

NPI Number	:	1366658122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARJORIE M BARR R. N., I.B.C.L.C.

Provider Business Mailing Address
First Line	:	18278 SUN MAIDEN CT
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92127-3103
Country	:	US
Telephone Number	:	858-592-2389
Fax Number	:

Provider Business Practice Location Address
First Line	:	18278 SUN MAIDEN CT
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92127-3103
Country	:	US
Telephone Number	:	858-592-2389
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	07/08/2007

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