Healthcare Provider Details

I. General information

NPI: 1942195920
Provider Name (Legal Business Name): NURTURE NUTRITION & LACTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 N BROAD ST E
ANGIER NC
27501-8954
US

IV. Provider business mailing address

1548 CAIRO WAY
FUQUAY VARINA NC
27526-5365
US

V. Phone/Fax

Practice location:
  • Phone: 919-275-1555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNULL

VIII. Authorized Official

Name: CARA MOWERY
Title or Position: OWNER
Credential: MS, RDN, LDN, IBCLC
Phone: 919-275-1555