Julie A Mattson, IBCLC, RN

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

2003006871 Issued in MO

Practice address

53 Highbush CT
Dardenne Prairie, MO 63368-9765

Phone

(314) 420-6331

NPI assigned

Jan 10, 2011

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

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": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1265736995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 HIGHBUSH CT",
            "city": "DARDENNE PRAIRIE",
            "state": "MO",
            "postal_code": "633689765",
            "telephone_number": "314-420-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 HIGHBUSH CT",
            "city": "DARDENNE PRAIRIE",
            "state": "MO",
            "postal_code": "633689765",
            "telephone_number": "314-420-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSON",
        "first_name": "JULIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "IBCLC, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-10",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MO",
            "license": "2003006871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Kruse
• Kristyn Linneman
• Little Smiles of Dardenne Prairie
• Andrew Lollar
• Cynthia Marcellino-Riley, PT
• Ninette Marie Matuszewski, OTR
• Nicole M McGowan, PHARM. D.
• Michele L Meyer
• Missouri CVS Pharmacy LLC
• Missouri CVS Pharmacy, L.L.C.

• Lactation Consultant (Registered Nurse) in Dardenne Prairie, MO
• Providers in Dardenne Prairie, MO by specialty
• Lactation Consultant (Registered Nurse) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; 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.