Provider Demographics
NPI:1982231007
Name:LAMB, MARION HENSON (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:HENSON
Last Name:LAMB
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 WILDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:VA
Mailing Address - Zip Code:22963-2225
Mailing Address - Country:US
Mailing Address - Phone:703-407-1415
Mailing Address - Fax:
Practice Address - Street 1:75 WILDWOOD DR
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:VA
Practice Address - Zip Code:22963-2225
Practice Address - Country:US
Practice Address - Phone:703-407-1415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA001070862163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty