Provider Demographics
NPI:1790040319
Name:NEWCOMB, AMBER M (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:M
Last Name:NEWCOMB
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 BROOKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-4815
Mailing Address - Country:US
Mailing Address - Phone:919-631-9947
Mailing Address - Fax:
Practice Address - Street 1:28 BROOKWOOD DR
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4815
Practice Address - Country:US
Practice Address - Phone:919-631-9947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC187981163WL0100X
MI4704191468163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant