Healthcare Provider Details

I. General information

NPI: 1174999023
Provider Name (Legal Business Name): NATURAL CHOICE BIRTH & BREASTFEEDING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2015
Last Update Date: 08/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 WYNNTON RD
COLUMBUS GA
31906-2919
US

IV. Provider business mailing address

5028 MONTEGO DR
COLUMBUS GA
31909-3423
US

V. Phone/Fax

Practice location:
  • Phone: 706-610-4332
  • Fax: 706-221-6870
Mailing address:
  • Phone: 706-610-4332
  • Fax: 706-221-6870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN05842
License Number StateGA

VIII. Authorized Official

Name: DEBRA ANN MILLER
Title or Position: OWENER/PROVIDER
Credential: RN, IBCLC
Phone: 706-610-4332