Provider Demographics
NPI:1609348945
Name:WARD, NATALIE BLYTHE (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:BLYTHE
Last Name:WARD
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 1:1910 ERIN CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-3551
Mailing Address - Country:US
Mailing Address - Phone:910-616-0120
Mailing Address - Fax:910-719-9019
Practice Address - Street 1:1910 ERIN CT
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-3551
Practice Address - Country:US
Practice Address - Phone:919-210-8846
Practice Address - Fax:910-719-9019
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-27
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL-152248174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN