Provider Demographics
NPI:1205608627
Name:LOVING, REBECCA (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:LOVING
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 1:3313 IRONSTONE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-3563
Mailing Address - Country:US
Mailing Address - Phone:512-618-9422
Mailing Address - Fax:
Practice Address - Street 1:3313 IRONSTONE RD
Practice Address - Street 2:
Practice Address - City:NORTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76226-3563
Practice Address - Country:US
Practice Address - Phone:512-618-9422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX967011163W00000X
TXL-303500163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse