Provider Demographics
NPI:1649095530
Name:RANKIN, CARLY (BSN, RN, IBCLC)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:RANKIN
Suffix:
Gender:F
Credentials:BSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 COMANCHE TRL
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-8118
Mailing Address - Country:US
Mailing Address - Phone:318-812-8272
Mailing Address - Fax:
Practice Address - Street 1:712 COMANCHE TRL
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-8118
Practice Address - Country:US
Practice Address - Phone:318-812-8272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN148101163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant