Provider Demographics
NPI:1144064361
Name:GROUNDED LACTATION
Entity type:Organization
Organization Name:GROUNDED LACTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:SINK
Authorized Official - Last Name:MOODY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC
Authorized Official - Phone:919-491-5939
Mailing Address - Street 1:702 SHEPHERD ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-3135
Mailing Address - Country:US
Mailing Address - Phone:919-491-5939
Mailing Address - Fax:984-287-7922
Practice Address - Street 1:702 SHEPHERD ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-3135
Practice Address - Country:US
Practice Address - Phone:919-491-5939
Practice Address - Fax:984-287-7922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty