Provider Demographics
NPI:1083385348
Name:MCCANN, REBECCA (IBCLC, RN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MCCANN
Suffix:
Gender:F
Credentials:IBCLC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5853
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-0601
Mailing Address - Country:US
Mailing Address - Phone:240-473-3471
Mailing Address - Fax:
Practice Address - Street 1:1165 BAKER HEIGHTS LOOP
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-2536
Practice Address - Country:US
Practice Address - Phone:240-473-3471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-25
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN.RN.61606576.MSL163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant