Healthcare Provider Details

I. General information

NPI: 1073936829
Provider Name (Legal Business Name): BLISS AT THE BREAST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2014
Last Update Date: 01/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 FLEMINGTON RD
CHAPEL HILL NC
27517-5637
US

IV. Provider business mailing address

231 FLEMINGTON RD
CHAPEL HILL NC
27517-5637
US

V. Phone/Fax

Practice location:
  • Phone: 919-260-7202
  • Fax:
Mailing address:
  • Phone: 919-260-7202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name: JESSICA D ALTEMARA
Title or Position: OWNER
Credential: IBCLC
Phone: 919-260-7202