Provider Demographics
NPI:1083385348
Name:MCCANN, REBECCA (IBCLC, RN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MCCANN
Suffix:
Gender:F
Credentials:IBCLC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4613 31ST RD S
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-1601
Mailing Address - Country:US
Mailing Address - Phone:425-894-0946
Mailing Address - Fax:
Practice Address - Street 1:4613 31ST RD S
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-1601
Practice Address - Country:US
Practice Address - Phone:425-894-0946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-25
Last Update Date:2021-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001297184163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant