Provider Demographics
NPI:1902560378
Name:MCLAUGHLIN, ABBEY RAE (RN, CLC)
Entity Type:Individual
Prefix:
First Name:ABBEY
Middle Name:RAE
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:RN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2078 E VISTA CIR
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-1617
Mailing Address - Country:US
Mailing Address - Phone:920-609-8532
Mailing Address - Fax:
Practice Address - Street 1:2078 E VISTA CIR
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-1617
Practice Address - Country:US
Practice Address - Phone:920-609-8532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI247919163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant