Jacqueline Komoroski, RN, IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

L-130081 Issued in GA

Practice address

6480 Pine Ridge Cir
Cumming, GA 30041-9265

Phone

(404) 783-5809

NPI assigned

Sep 1, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Jackie Komoroski Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1093435703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 PINE RIDGE CIR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300419265",
            "telephone_number": "404-783-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6480 PINE RIDGE CIR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300419265",
            "telephone_number": "404-783-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMOROSKI",
        "first_name": "JACQUELINE",
        "name_prefix": "Ms.",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "GA",
            "license": "L-130081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://go.lactationnetwork.com/JackieKLactation",
            "affiliation": "N",
            "endpointDescription": "Lactation Network",
            "address_1": "6480 Pine Ridge Cir",
            "city": "Cumming",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300419265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "KOMOROSKI",
            "prefix": "MS.",
            "credential": "RN, IBCLC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mojgan A Kobari, PHARM D
• Cassie Kobetich, MS
• Kimberly Kobetich, FNP
• Helen Laurie Kochilas, AUD
• Anna Kolomitseva, LICENSED ND
• Kristina Konieczny
• Ansley Konkle, MS, CCC-SLP
• Grace Kim Koo, FNP-C
• Jeanne L. Kopacka, PA
• Anna Kops

• Lactation Consultant (Registered Nurse) in Cumming, GA
• Providers in Cumming, GA by specialty
• Lactation Consultant (Registered Nurse) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.