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General NPI Number Information
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NPI Number | 1871330134
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Entity Type | Individual
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Provider Name | JACQUELYN GARCIA CPNP-AC, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 07/12/2024
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 1000 BLYTHE BLVD
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City | CHARLOTTE
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State | NC
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Zip | 28203-5812
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Country | US
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Telephone | 704-355-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 110 AVERILL LN
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City | IRMO
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State | SC
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Zip | 29063-8777
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Country | US
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Telephone | 786-274-2543
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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 | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | L-152686
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 29506
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363LP0222X
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Taxonomy Name | Critical Care Pediatric Nurse Practitioner
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License Number | GAA-NP002412
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 363LP0222X
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Taxonomy Name | Critical Care Pediatric Nurse Practitioner
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License Number | 5021064
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License Number State | NC
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