Provider Demographics
NPI:1790510360
Name:ALBERT, LORA (RN, BSN, IBCLC, HC)
Entity type:Individual
Prefix:
First Name:LORA
Middle Name:
Last Name:ALBERT
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC, HC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 ROBERTS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:IA
Mailing Address - Zip Code:52340-9403
Mailing Address - Country:US
Mailing Address - Phone:928-699-7839
Mailing Address - Fax:
Practice Address - Street 1:474 ROBERTS FERRY RD
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:IA
Practice Address - Zip Code:52340-9403
Practice Address - Country:US
Practice Address - Phone:928-699-7839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA139535163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant