Provider Demographics
NPI:1346817293
Name:THORNTON, RUTH ANNE (IBCLC, RN)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ANNE
Last Name:THORNTON
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 1:3004 WESTERN OAK DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-5159
Mailing Address - Country:US
Mailing Address - Phone:530-941-6143
Mailing Address - Fax:
Practice Address - Street 1:3004 WESTERN OAK DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-5159
Practice Address - Country:US
Practice Address - Phone:530-941-6143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA757656163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant