Individual provider Active NPI

Maryann Solt Eisemann, REGISTERED NURSE

  • Lactation Consultant (Registered Nurse)
  • Jacksonville, FL
National Provider Identifier
1386829646
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
RN9368677 Issued in FL
Practice address
4605 Princess Anne LN
Jacksonville, FL 32210-7526
Phone
(570) 263-0555
Fax
(904) 638-4765
NPI assigned
Jan 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X RN9368677 FL Primary

Addresses

Primary practice location

4605 Princess Anne LN
Jacksonville, FL 32210-7526

Mailing address

4605 Princess Anne LN
Jacksonville, FL 32210-7526
Phone (570) 263-0555

Other practice location 1

1100 Grampian Blvd
Williamsport, PA 17701-1909
Phone (570) 320-7690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN9368677FLMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1386829646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 PRINCESS ANNE LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322107526",
            "telephone_number": "570-263-0555",
            "fax_number": "904-638-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 PRINCESS ANNE LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322107526",
            "telephone_number": "570-263-0555",
            "fax_number": "904-638-4765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Grampian Blvd",
            "address_purpose": "LOCATION",
            "city": "Williamsport",
            "state": "PA",
            "postal_code": "177011909",
            "country_code": "US",
            "telephone_number": "570-320-7690",
            "fax_number": "570-320-7898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EISEMANN",
        "first_name": "MARYANN",
        "middle_name": "SOLT",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "FL",
            "license": "RN9368677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.