Katherine Rose Mac, I.B.C.L.C.

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

11295806 Issued in NU

Practice address

108 Summit Loop
C3
Carbondale, CO 81623-8792

Phone

(734) 391-5547

NPI assigned

Mar 23, 2011

Last updated

Apr 25, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Katherine Rose Gietzen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366848000000",
    "number": "1063711422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 SUMMIT LOOP",
            "address_2": "C3",
            "city": "CARBONDALE",
            "state": "CO",
            "postal_code": "816238792",
            "telephone_number": "734-391-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 SUMMIT LOOP",
            "address_2": "C3",
            "city": "CARBONDALE",
            "state": "CO",
            "postal_code": "816238792",
            "telephone_number": "734-391-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAC",
        "first_name": "KATHERINE",
        "middle_name": "ROSE",
        "credential": "I.B.C.L.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-23",
        "last_updated": "2013-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "NU",
            "license": "11295806",
            "primary": true
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "GIETZEN",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Lactation Consultant (Non-RN) in Carbondale, CO
• Providers in Carbondale, CO by specialty
• Lactation Consultant (Non-RN) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; 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.