Kristen Jacobs, RN, IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

28184331A Issued in IN

Practice address

11207 Mallory CT
Roanoke, IN 46783-8602

Phone

(260) 615-6883

NPI assigned

Jul 12, 2023

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": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1295414845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11207 MALLORY CT",
            "city": "ROANOKE",
            "state": "IN",
            "postal_code": "467838602",
            "telephone_number": "260-255-4360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11207 MALLORY CT",
            "city": "ROANOKE",
            "state": "IN",
            "postal_code": "467838602",
            "telephone_number": "260-615-6883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "KRISTEN",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "IN",
            "license": "28184331A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Michael Bowers, PTA
• Child'S Play Behavior Analysis
• Matthew Lee Debolt, PTA
• Jon Heidi Downey, RN, BSN
• Sierra N Estep
• Phillip L. Jones, D.D.S.
• Molly A Kelly, MD
• Theppanya Ka Keolasy, MD
• Stephanie S Kidd, DO
• Mark A King, DO

• Lactation Consultant (Registered Nurse) in Roanoke, IN
• Providers in Roanoke, IN by specialty
• Lactation Consultant (Registered Nurse) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.