Provider Demographics
NPI:1770029001
Name:LAKE NORMAN BREASTFEEDING SOLUTIONS LLC
Entity Type:Organization
Organization Name:LAKE NORMAN BREASTFEEDING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HONEA
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:704-779-3173
Mailing Address - Street 1:522 POTTS ST
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-8406
Mailing Address - Country:US
Mailing Address - Phone:704-779-3173
Mailing Address - Fax:704-896-4907
Practice Address - Street 1:522 POTTS ST
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-8406
Practice Address - Country:US
Practice Address - Phone:704-997-9406
Practice Address - Fax:704-896-4907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-10
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty