Provider Demographics
NPI:1194130617
Name:MILES, LORRAINE MARIE (RN, IBCLC-RLC)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:MARIE
Last Name:MILES
Suffix:
Gender:F
Credentials:RN, IBCLC-RLC
Other - Prefix:
Other - First Name:LORRAINE
Other - Middle Name:MARIE
Other - Last Name:HUGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20474 VARSITY DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-1219
Mailing Address - Country:US
Mailing Address - Phone:909-595-9620
Mailing Address - Fax:
Practice Address - Street 1:20474 VARSITY DR
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-1219
Practice Address - Country:US
Practice Address - Phone:909-595-9620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN508531163W00000X
CAL-33010163WL0100X
174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No174H00000XOther Service ProvidersHealth Educator