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Individual

SOPHIA TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN,IBCLC

Contact information

Practice address
7272 SHELLBURNE DR, RALEIGH, NC 27612-2480
(919) 862-3479
Mailing address
7272 SHELLBURNE DR, RALEIGH, NC 27612-2480
(919) 862-3479

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
89069
NC
174N00000X
Lactation Consultant (Non-RN)
L-311772
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
330702
CERTIFIED LACTATION COUNSELOR CLC THROUGH ALPP
NC
01
89069
LICENSED PRACTICAL NURSE
NC
01
L-311772
IBLCE
NC
Enumeration date
09/12/2022
Last updated
07/19/2023
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