Healthcare Provider Details

I. General information

NPI: 1689494650
Provider Name (Legal Business Name): CAROLINA BIRTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2024
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5850 FAYETTEVILLE RD STE 202
DURHAM NC
27713-6289
US

IV. Provider business mailing address

5850 FAYETTEVILLE RD STE 202
DURHAM NC
27713-6289
US

V. Phone/Fax

Practice location:
  • Phone: 919-480-1423
  • Fax: 919-820-8263
Mailing address:
  • Phone: 919-480-1423
  • Fax: 919-820-8263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name: EMILY CHAFFEE
Title or Position: OWNER
Credential:
Phone: 919-480-1423