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Individual

KACEY LAINE HECKATHORN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, BSN, IBCLC

Contact information

Practice address
9925 MORGANTOWN RD, NEWBURG, MD 20664-2318
(240) 320-4202
Mailing address
9925 MORGANTOWN RD, NEWBURG, MD 20664-2318
(240) 320-4202

Taxonomy

Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
L-309407
MD
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
R232561
MD

Other

Enumeration date
09/18/2023
Last updated
09/18/2023
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