Provider Demographics
NPI:1285015651
Name:BARCLAY, HOLLIE (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:HOLLIE
Middle Name:
Last Name:BARCLAY
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 ROCKY HILL RD
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH
Mailing Address - State:MA
Mailing Address - Zip Code:02769-1520
Mailing Address - Country:US
Mailing Address - Phone:508-431-0850
Mailing Address - Fax:
Practice Address - Street 1:18 ROCKY HILL RD
Practice Address - Street 2:
Practice Address - City:REHOBOTH
Practice Address - State:MA
Practice Address - Zip Code:02769-1520
Practice Address - Country:US
Practice Address - Phone:508-431-0850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2286428163W00000X, 163WH0200X, 163WM0102X
MAL-45477163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn