Taylor Mack, RN, CLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

RN.464564 Issued in OH

Practice address

263 Hidden Village CT
Holland, OH 43528-6602

Phone

(517) 410-5494

NPI assigned

Mar 3, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1295320166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 HIDDEN VILLAGE CT",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435286602",
            "telephone_number": "517-410-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 HIDDEN VILLAGE CT",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435286602",
            "telephone_number": "517-410-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "TAYLOR",
        "credential": "RN, CLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MI",
            "license": "4707335337",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "OH",
            "license": "RN.464564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lutheran Orphans and Old Folks Home at Wolf Creek
• Sarah Elizabeth Lyczkowski, CDCA
• Kristin Lynam
• Earth Lyons
• Michael Edward Mack, DMD
• Megan M Mahon, PH.D., PCC-S
• Yasser Malik, MD
• Allison Malone, M.A. CCC-SLP
• Lydia Manes
• Gina Alessandra Mariani, MSW, LISW

• Lactation Consultant (Registered Nurse) in Holland, OH
• Providers in Holland, OH by specialty
• Lactation Consultant (Registered Nurse) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.