=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326314485
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LEAH L TROMBLEY WHNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2012
-----------------------------------------------------
Last Update Date | 12/28/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 801 MCCARTHY BLVD
-----------------------------------------------------
City | NEW BERN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28562-5237
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-633-3942
-----------------------------------------------------
Fax | 252-633-3332
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 801 MCCARTHY BLVD
-----------------------------------------------------
City | NEW BERN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28562-5237
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-633-3942
-----------------------------------------------------
Fax | 252-633-3332
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WL0100X
-----------------------------------------------------
Taxonomy Name | Lactation Consultant (Registered Nurse)
-----------------------------------------------------
License Number | 171124
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number | 5005561
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------