Provider Demographics
NPI:1851197644
Name:MCGIVERN, KATHERINE (RN IBCLC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:MCGIVERN
Suffix:
Gender:
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 1:278 STANMORE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-1136
Mailing Address - Country:US
Mailing Address - Phone:410-218-7704
Mailing Address - Fax:
Practice Address - Street 1:278 STANMORE RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-1136
Practice Address - Country:US
Practice Address - Phone:410-218-7704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR165491163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant