Organization
WELLBORN UPSTATE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER STEWART IBCLC, CPM, LM (OWNER, LM)
(909) 575-7323
Entity
Organization
Contact information
Practice address
902 N PLEASANTBURG DR STE C, GREENVILLE, SC 29607-1600
(864) 583-5831
(888) 340-7874
Mailing address
1955 DRAYTON RD UNIT 832, DRAYTON, SC 29333-5030
(909) 575-7323
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
—
—
176B00000X
Midwife
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245520774
NPPES
—
Enumeration date
04/13/2019
Last updated
07/28/2023
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