Provider Demographics
NPI:1770055857
Name:LYNNE RICARDO RN IBCLC LLC
Entity type:Organization
Organization Name:LYNNE RICARDO RN IBCLC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICARDO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC
Authorized Official - Phone:508-944-5129
Mailing Address - Street 1:1 CANDLEWICK LN
Mailing Address - Street 2:
Mailing Address - City:WHITMAN
Mailing Address - State:MA
Mailing Address - Zip Code:02382-1612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 CANDLEWICK LN
Practice Address - Street 2:
Practice Address - City:WHITMAN
Practice Address - State:MA
Practice Address - Zip Code:02382-1612
Practice Address - Country:US
Practice Address - Phone:508-944-5129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-29
Last Update Date:2018-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty