Individual provider Active NPI

Lynnette Guy Crocker, RN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Delray Beach, FL
National Provider Identifier
1508131749
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
1077972 Issued in FL
Practice address
22 NW 24TH CT
Delray Beach, FL 33444-4318
Phone
(561) 278-9461
Fax
(561) 278-9461
NPI assigned
Mar 21, 2012
Last updated
Mar 21, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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 1077972 FL Primary

Addresses

Primary practice location

22 NW 24TH CT
Delray Beach, FL 33444-4318

Mailing address

22 NW 24TH CT
Delray Beach, FL 33444-4318
Phone (561) 278-9461

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
1077972FLMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1508131749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 NW 24TH CT",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334444318",
            "telephone_number": "561-278-9461",
            "fax_number": "561-278-9461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 NW 24TH CT",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334444318",
            "telephone_number": "561-278-9461",
            "fax_number": "561-278-9461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "LYNNETTE",
        "middle_name": "GUY",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-21",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "FL",
            "license": "1077972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.