Brandi Michelle Crockett, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L-58067 Issued in WA

Practice address

202 N Bogart Ave
Granite Falls, WA 98252-8406

Phone

(425) 327-7491

NPI assigned

May 22, 2015

Last updated

May 22, 2015By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432252800000",
    "number": "1568841617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N BOGART AVE",
            "city": "GRANITE FALLS",
            "state": "WA",
            "postal_code": "982528406",
            "telephone_number": "425-327-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N BOGART AVE",
            "city": "GRANITE FALLS",
            "state": "WA",
            "postal_code": "982528406",
            "telephone_number": "425-327-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "BRANDI",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-22",
        "last_updated": "2015-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "WA",
            "license": "L-58067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lactation Consultant (Non-RN) in Granite Falls, WA
• Providers in Granite Falls, WA by specialty
• Lactation Consultant (Non-RN) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; 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.