Provider Demographics
NPI:1922418839
Name:CROSSEN, RACHEL WHITNEY (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:WHITNEY
Last Name:CROSSEN
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5019 HIDEAWAY HILL LANE
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:VA
Mailing Address - Zip Code:20115
Mailing Address - Country:US
Mailing Address - Phone:540-270-8230
Mailing Address - Fax:
Practice Address - Street 1:5019 HIDEAWAY HILL LN
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:VA
Practice Address - Zip Code:20115-2862
Practice Address - Country:US
Practice Address - Phone:540-270-8230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA11184844174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA11184844OtherIBCLC