Individual provider Active NPI

Grace Maria Doolittle, RNC, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Minneapolis, MN
National Provider Identifier
1073867347
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
R935337 Issued in MN
Practice address
2450 Riverside Ave
Nicu 4TH Floor East Building
Minneapolis, MN 55454-1450
Phone
(612) 273-7624
Fax
(612) 273-7625
NPI assigned
Nov 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X R935337 MN Primary

Addresses

Primary practice location

2450 Riverside Ave
Nicu 4TH Floor East Building
Minneapolis, MN 55454-1450

Mailing address

2450 Riverside Ave
Nicu 4TH Floor East Building
Minneapolis, MN 55454-1450
Phone (612) 273-7624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R935337MNMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1073867347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "address_2": "NICU 4TH FLOOR EAST BUILDING",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-273-7624",
            "fax_number": "612-273-7625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "address_2": "NICU 4TH FLOOR EAST BUILDING",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-273-7624",
            "fax_number": "612-273-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOLITTLE",
        "first_name": "GRACE",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "RNC, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-07",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MN",
            "license": "R935337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; 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.