Provider Demographics
NPI:1639517212
Name:IVKER, LINDA ANN (RNC-OB IBCLC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ANN
Last Name:IVKER
Suffix:
Gender:F
Credentials:RNC-OB IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 TOWNSHIP LINE RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1542
Mailing Address - Country:US
Mailing Address - Phone:215-512-0075
Mailing Address - Fax:
Practice Address - Street 1:1028 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1542
Practice Address - Country:US
Practice Address - Phone:215-512-0075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA11037275163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant