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NPI Code Detail

MEDICARE: SUSAN R. O'HARA-BRILL IBCLC, RLC

MEDICARE: SUSAN R. O'HARA-BRILL IBCLC, RLC
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
1174400000XSpecialist100-16735NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1100-16735OTHERNCREGISTERED LACTATION CONS

General Provider Information

NPI Number : 1174731301
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN R. O'HARA-BRILL IBCLC, RLC
Provider Business Mailing Address
First Line : 113 HIDDEN VALLEY DR
Second Line :
City : CHAPEL HILL
State : NC
Zip : 27516-8949
Country : US
Telephone Number : 919-423-8943
Fax Number : 919-967-6928
Provider Business Practice Location Address
First Line : 113 HIDDEN VALLEY DR
Second Line :
City : CHAPEL HILL
State : NC
Zip : 27516-8949
Country : US
Telephone Number : 919-423-8943
Fax Number : 919-967-6928
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2007
Last Update Date : 07/08/2007

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