Provider Demographics
NPI:1023909918
Name:BUCKWAY, LORILIN HAWKES (RN,IBCLC)
Entity type:Individual
Prefix:
First Name:LORILIN
Middle Name:HAWKES
Last Name:BUCKWAY
Suffix:
Gender:F
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 1:6836 S 1600 E
Mailing Address - Street 2:
Mailing Address - City:UINTAH
Mailing Address - State:UT
Mailing Address - Zip Code:84405-9795
Mailing Address - Country:US
Mailing Address - Phone:801-643-6022
Mailing Address - Fax:
Practice Address - Street 1:6836 S 1600 E
Practice Address - Street 2:
Practice Address - City:UINTAH
Practice Address - State:UT
Practice Address - Zip Code:84405-9795
Practice Address - Country:US
Practice Address - Phone:801-643-6022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT260414-3102163W00000X
UTL318411174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No174N00000XOther Service ProvidersLactation Consultant, Non-RN