MEDICARE: NICHOLE LUBRANO NBCHWC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach	A-3238946

General Provider Information

NPI Number	:	1023758448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLE LUBRANO NBCHWC

Provider Business Mailing Address
First Line	:	3132 LONE CREEK RD
Second Line	:
City	:	NEW HILL
State	:	NC
Zip	:	27562-9703
Country	:	US
Telephone Number	:	191-025-7345
Fax Number	:

Provider Business Practice Location Address
First Line	:	3132 LONE CREEK RD
Second Line	:
City	:	NEW HILL
State	:	NC
Zip	:	27562-9703
Country	:	US
Telephone Number	:	191-025-7345
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2022
Last Update Date	:	04/01/2022

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