Provider Demographics
NPI:1912774936
Name:SUN, RACHEL JONES (IBCLC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:JONES
Last Name:SUN
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:MAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:IBCLC
Mailing Address - Street 1:1590 GOSHEN RD APT B
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-9141
Mailing Address - Country:US
Mailing Address - Phone:706-410-5785
Mailing Address - Fax:
Practice Address - Street 1:1590 GOSHEN RD APT B
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-9141
Practice Address - Country:US
Practice Address - Phone:706-410-5785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALC000197174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN