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General NPI Number Information
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NPI Number | 1760564421
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Entity Type | Individual
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Provider Name | ELIZABETH GEORGANNA COGBURN RD, LDN, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 03/15/2016
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Provider Practice Location Address
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Address Line | 119 HENDERSONVILLE RD
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City | ASHEVILLE
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State | NC
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Zip | 28803-2868
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Country | US
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Telephone | 828-771-5500
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Fax | 828-771-5454
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Provider Business Mailing Address
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Address Line | 20 RIDGE CROSS RD
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City | ASHEVILLE
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State | NC
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Zip | 28805-9277
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Country | US
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Telephone | 828-298-6965
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | L000698
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number | 192-10865
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License Number State | NC
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