Healthcare Provider Details

I. General information

NPI: 1902341498
Provider Name (Legal Business Name): RACHEL CAROLINE MCGILL RN, BSN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL CAROLINE PICKNER RN, BSN

II. Dates (important events)

Enumeration Date: 12/20/2016
Last Update Date: 12/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 W NORFOLK AVE
NORFOLK NE
68701-4438
US

IV. Provider business mailing address

2700 W NORFOLK AVE
NORFOLK NE
68701-4438
US

V. Phone/Fax

Practice location:
  • Phone: 712-389-1224
  • Fax:
Mailing address:
  • Phone: 712-389-1224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number78467
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: