Ilyssa Karen Haar, RN, IBCLC, BSN

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

R209600 Issued in MD

Practice address

655 Watkins Mill Rd
Gaithersburg, MD 20879-3301

Phone

(240) 632-4333

NPI assigned

Sep 20, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1033760160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 WATKINS MILL RD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793301",
            "telephone_number": "240-632-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 WATKINS MILL RD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793301",
            "telephone_number": "240-632-4333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10810 Conn Ave",
            "address_purpose": "LOCATION",
            "city": "Kensington",
            "state": "MD",
            "postal_code": "208952138",
            "country_code": "US",
            "telephone_number": "240-632-4333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAAR",
        "first_name": "ILYSSA",
        "middle_name": "KAREN",
        "credential": "RN, IBCLC, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-20",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MD",
            "license": "R209600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lactation Consultant (Registered Nurse) in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Lactation Consultant (Registered Nurse) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.