Basic Information
| Provider Information | |||||||||
| NPI: | 1861664443 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALBRECHT | ||||||||
| FirstName: | NANCY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5405 FARLEY DR | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276094413 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 930 MARTIN LUTHER KING JR BLVD | ||||||||
| Address2: | STE. 202 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275142656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199333301 | ||||||||
| FaxNumber: | 9199333375 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2008 | ||||||||
| LastUpdateDate: | 03/24/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WL0100X | 145542 | NC | Y | Nursing Service Providers | Registered Nurse | Lactation Consultant |
ID Information
| ID | Type | State | Issuer | Description | 015PN | 01 | NC | BLUE CROSS GROUP NUMBER | OTHER | 208391 | 01 | NC | WELLPATH GROUP NUMBER | OTHER | 208391 | 01 | MEDCOST GROUP NUMBER | OTHER | 7000091 | 05 | NC | MEDICAID | 002419079001 | 01 | UNITED HEALTHCARE GROUP | OTHER |