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NPI Code Detail

MEDICARE: SARAH C BRUNSON RN, IBCLC, RLC

MEDICARE: SARAH C BRUNSON RN, IBCLC, RLC
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
1163W00000XRegistered Nurse226359SC
2163WL0100XLactation Consultant (Registered Nurse)226359SC

General Provider Information

NPI Number : 1922336536
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH C BRUNSON RN, IBCLC, RLC
Provider Business Mailing Address
First Line : 9133 TIMBER ST
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9075
Country : US
Telephone Number : 843-818-1123
Fax Number :
Provider Business Practice Location Address
First Line : 9133 TIMBER ST
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9075
Country : US
Telephone Number : 843-818-1123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2009
Last Update Date : 11/22/2016

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