Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 123564 | NC |
NPI | 1245581701 |
---|---|
Provider Name | Linda C Donovan |
First Address | Greensboro, NC 27403-1835 |
Second Address | Greensboro, NC 27401-2706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2012 |
Last Update Date | 25/09/2012 |