Individual provider Active NPI

Dashea Nikkole Line, RN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • San Antonio, TX
National Provider Identifier
1487478913
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
780770 Issued in TX
Practice address
1231 Yellow Warbler Run
San Antonio, TX 78253-2319
Phone
(806) 367-0520
NPI assigned
Nov 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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)Group: 193400000X SINGLE SPECIALTY GROUP 163WL0100X 780770 TX Primary

Addresses

Primary practice location

1231 Yellow Warbler Run
San Antonio, TX 78253-2319

Mailing address

1231 Yellow Warbler Run
San Antonio, TX 78253-2319
Phone (806) 367-0520

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
780770TXMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1731369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1487478913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 YELLOW WARBLER RUN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782532319",
            "telephone_number": "806-367-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 YELLOW WARBLER RUN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782532319",
            "telephone_number": "806-367-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINE",
        "first_name": "DASHEA",
        "middle_name": "NIKKOLE",
        "name_prefix": "Mrs.",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "TX",
            "license": "780770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.