Provider Demographics
NPI:1730333022
Name:JAMISON, LOURDES M (RN, BSN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:M
Last Name:JAMISON
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 CHALLENGE AVE
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-8511
Mailing Address - Country:US
Mailing Address - Phone:951-769-3033
Mailing Address - Fax:
Practice Address - Street 1:824 CHALLENGE AVE
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-8511
Practice Address - Country:US
Practice Address - Phone:951-769-3033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA623846163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant