Provider Demographics
NPI:1366658122
Name:BARR, MARJORIE M (R N, IBCLC)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:M
Last Name:BARR
Suffix:
Gender:F
Credentials:R N, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18278 SUN MAIDEN CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-3103
Mailing Address - Country:US
Mailing Address - Phone:858-592-2389
Mailing Address - Fax:
Practice Address - Street 1:18278 SUN MAIDEN CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-3103
Practice Address - Country:US
Practice Address - Phone:858-592-2389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA448769163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant