Provider Demographics
NPI:1669299442
Name:ROHN, TERRA M (IBCLC,CLC)
Entity type:Individual
Prefix:
First Name:TERRA
Middle Name:M
Last Name:ROHN
Suffix:
Gender:F
Credentials:IBCLC,CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6730 KALINOWSKI ST
Mailing Address - Street 2:
Mailing Address - City:TARAWA TERRACE
Mailing Address - State:NC
Mailing Address - Zip Code:28543-1404
Mailing Address - Country:US
Mailing Address - Phone:603-717-2596
Mailing Address - Fax:
Practice Address - Street 1:720 NEW BRIDGE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-5435
Practice Address - Country:US
Practice Address - Phone:910-333-6664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL-313602174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN