Healthcare Provider Details

I. General information

NPI: 1588590509
Provider Name (Legal Business Name): REBECCA LYNN FOLEY RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2607 VINEVILLE AVE STE 107
MACON GA
31204-0900
US

IV. Provider business mailing address

1825 HARLIN DAY RD
MC INTYRE GA
31054-2187
US

V. Phone/Fax

Practice location:
  • Phone: 478-288-8784
  • Fax: 478-254-9157
Mailing address:
  • Phone: 501-533-4028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN153005
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN153005
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: