Denise M Wall, LPN, IBCLC, RLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

11010140 Issued in VA

Practice address

519 Cross Creek Way
Palmyra, VA 22963-4904

Phone

(434) 962-7414

NPI assigned

Mar 9, 2012

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

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

{
    "created_epoch": "1331251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1295000115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 CROSS CREEK WAY",
            "city": "PALMYRA",
            "state": "VA",
            "postal_code": "229634904",
            "telephone_number": "434-962-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 CROSS CREEK WAY",
            "city": "PALMYRA",
            "state": "VA",
            "postal_code": "229634904",
            "telephone_number": "434-962-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "DENISE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LPN, IBCLC, RLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-09",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "VA",
            "license": "11010140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lactation Consultant (Non-RN) in Palmyra, VA
• Providers in Palmyra, VA by specialty
• Lactation Consultant (Non-RN) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.