Provider Demographics
NPI:1114679602
Name:MCCOY, ABRIE LYNN (IBCLC)
Entity Type:Individual
Prefix:
First Name:ABRIE
Middle Name:LYNN
Last Name:MCCOY
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4597 VIRSALLI LOOP
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-9430
Mailing Address - Country:US
Mailing Address - Phone:248-872-8110
Mailing Address - Fax:
Practice Address - Street 1:4597 VIRSALLI LOOP
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-9430
Practice Address - Country:US
Practice Address - Phone:248-872-8110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPP-312510174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPP-312510OtherTHE ACADEMY OF LACTATION POLICY AND PRACTICE
L-310874OtherINTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS