Provider Demographics
NPI:1154043594
Name:MOYO, MEGAN CHRISTINE (RN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:CHRISTINE
Last Name:MOYO
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 1:2344 PARK GARDEN CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-8675
Mailing Address - Country:US
Mailing Address - Phone:637-192-8893
Mailing Address - Fax:
Practice Address - Street 1:518 BEAUMONT RD STE 102
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4447
Practice Address - Country:US
Practice Address - Phone:910-486-8705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC349547163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant