Provider Demographics
NPI:1912282013
Name:HEYDE-MCCOY, ROBIN H (RNC IBCLC)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:H
Last Name:HEYDE-MCCOY
Suffix:
Gender:F
Credentials:RNC IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31705 ROAD 226
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:CA
Mailing Address - Zip Code:93221-9536
Mailing Address - Country:US
Mailing Address - Phone:559-288-0430
Mailing Address - Fax:
Practice Address - Street 1:31705 ROAD 226
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:CA
Practice Address - Zip Code:93221-9536
Practice Address - Country:US
Practice Address - Phone:559-288-0430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA482211163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant