Healthcare Provider Details

I. General information

NPI: 1851169304
Provider Name (Legal Business Name): THE BETTER BOOB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2023
Last Update Date: 12/14/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 W HARGETT ST RM 1012
RALEIGH NC
27601-1377
US

IV. Provider business mailing address

105 LOCKHEED CIR
CARY NC
27513-9402
US

V. Phone/Fax

Practice location:
  • Phone: 850-404-2662
  • Fax:
Mailing address:
  • Phone: 850-404-2662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: COURTNEY MILLER
Title or Position: OWNER
Credential: RN, IBCLC
Phone: 850-404-2662