Provider Demographics
NPI:1205335312
Name:LORD, RACHEL (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:LORD
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 1:4200 31ST ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-1732
Mailing Address - Country:US
Mailing Address - Phone:301-452-4260
Mailing Address - Fax:
Practice Address - Street 1:4200 31ST ST
Practice Address - Street 2:
Practice Address - City:MOUNT RAINIER
Practice Address - State:MD
Practice Address - Zip Code:20712-1732
Practice Address - Country:US
Practice Address - Phone:301-452-4260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-03
Last Update Date:2018-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR215981163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant