Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | 102-18003 | NC |
NPI | 1306150750 |
---|---|
Provider Name | Jennifer Moss Corbin |
First Address | Charlotte, NC 28226-6644 |
Second Address | Charlotte, NC 28226-6644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2010 |
Last Update Date | 14/03/2013 |