Provider Demographics
NPI:1013747997
Name:MCLOUGHLIN, KRISTIN MARY (RN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:MARY
Last Name:MCLOUGHLIN
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 FROG HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:POUGHQUAG
Mailing Address - State:NY
Mailing Address - Zip Code:12570-5711
Mailing Address - Country:US
Mailing Address - Phone:845-222-2866
Mailing Address - Fax:
Practice Address - Street 1:200 WESTAGE BUSINESS CTR DR STE 230
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2288
Practice Address - Country:US
Practice Address - Phone:845-896-9864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY484217163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant