Provider Demographics
NPI:1760905392
Name:RUHLEN, REBECCA NANCY (PHD, IBCLC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:NANCY
Last Name:RUHLEN
Suffix:
Gender:F
Credentials:PHD, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2240
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-2240
Mailing Address - Country:US
Mailing Address - Phone:704-997-9190
Mailing Address - Fax:
Practice Address - Street 1:558 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-9475
Practice Address - Country:US
Practice Address - Phone:704-728-8665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN