Individual provider Active NPI

Natasha Kay Mizner, RN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Shawnee, KS
National Provider Identifier
1114665353
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
136401 Issued in KS
Practice address
6614 Goode Dr
Shawnee, KS 66216-2515
Phone
(402) 690-1689
NPI assigned
May 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2022

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 136401 KS Primary

Addresses

Primary practice location

6614 Goode Dr
Shawnee, KS 66216-2515

Mailing address

6614 Goode Dr
Shawnee, KS 66216-2515
Phone (402) 690-1689

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
136401KSMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Good Life Lactation LLC Lactation Consultant CurrentSince Nov 17, 2024 Accepting new patients

Locations

7398 W 162nd Ter
Stilwell, KS 66085
Phone (913) 484-7632

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1114665353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6614 GOODE DR",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662162515",
            "telephone_number": "402-690-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6614 GOODE DR",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662162515",
            "telephone_number": "402-690-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZNER",
        "first_name": "NATASHA",
        "middle_name": "KAY",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "KS",
            "license": "136401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.