Autumn Wake

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

RN56095 Issued in NV

Practice address

6581 Ironbound Bay Ave
Las Vegas, NV 89139-6130

Phone

(904) 613-8255

NPI assigned

Apr 11, 2017

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

State licenses

Practice roles

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.

• Lactation Consultants of America

  • Lactation Consultant (Non-RN)
  • Big Bear City, CA
  • NPI 1740929694
  NPD (past)

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1285168732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6581 IRONBOUND BAY AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891396130",
            "telephone_number": "904-613-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6581 IRONBOUND BAY AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891396130",
            "telephone_number": "904-613-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKE",
        "first_name": "AUTUMN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-11",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NV",
            "license": "RN56095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Queton A Waite
• Torie Waite, LCSW
• Daniel Waiters
• Kendall Waithe
• Gabriele Maria Waits, MFT
• Jordan Lee Wakefield
• Maria C Wakefield
• Tracy J Wakefield, MD
• William M. Wakefield, M.D.
• Amanda Kari Wakershauser

• Lactation Consultant (Registered Nurse) in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Lactation Consultant (Registered Nurse) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.