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NPI Code Detail

MEDICARE: REBECCA HOPE GUY RN, CLC, IBCLC

MEDICARE:   REBECCA HOPE GUY  RN, CLC, IBCLC
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
1163WL0100XLactation Consultant (Registered Nurse)L-161895NC

General Provider Information

NPI Number : 1598497414
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA HOPE GUY RN, CLC, IBCLC
Provider Business Mailing Address
First Line : 310 NEW BRIDGE ST
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28540-4756
Country : US
Telephone Number : 910-621-4266
Fax Number :
Provider Business Practice Location Address
First Line : 310 NEW BRIDGE ST
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28540-4756
Country : US
Telephone Number : 910-621-4266
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2022
Last Update Date : 06/29/2022

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