Healthcare Provider Details

I. General information

NPI: 1861310526
Provider Name (Legal Business Name): BLOOM & LATCH LACTATION CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 OLD BUCKHORN RD
GARNER NC
27529-3770
US

IV. Provider business mailing address

1411 OLD BUCKHORN RD
GARNER NC
27529-3770
US

V. Phone/Fax

Practice location:
  • Phone: 919-607-9152
  • Fax:
Mailing address:
  • Phone: 919-607-9152
  • 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: CATHERINE CONCEPCION
Title or Position: OWNER
Credential: CCMA
Phone: 919-607-9152