Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 10885649 | NC |
NPI | 1093059552 |
---|---|
Provider Name | Ms. Nicole Mcintyre Waters |
First Address | Charlotte, NC 28270-2295 |
Second Address | Charlotte, NC 28270-2295 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2012 |
Last Update Date | 21/11/2012 |