MEDICARE: MRS. NICOLA SINGLETARY IBCLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174N00000X	Lactation Consultant (Non-RN)	L-41888

General Provider Information

NPI Number	:	1033540968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NICOLA SINGLETARY IBCLC

Provider Business Mailing Address
First Line	:	3517 BOSCO RD
Second Line	:
City	:	NEW HILL
State	:	NC
Zip	:	27562-9111
Country	:	US
Telephone Number	:	919-610-8089
Fax Number	:

Provider Business Practice Location Address
First Line	:	3517 BOSCO RD
Second Line	:
City	:	NEW HILL
State	:	NC
Zip	:	27562-9111
Country	:	US
Telephone Number	:	919-610-8089
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2013
Last Update Date	:	12/03/2013

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