Heather Ann Buquoi-Ellison, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

11198976 Issued in TX

Practice address

4159 Steck Ave
Unit 111
Austin, TX 78759-8585

Phone

(225) 620-7589

NPI assigned

Nov 12, 2015

Last updated

Nov 12, 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": "1447286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1710350707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4159 STECK AVE",
            "address_2": "UNIT 111",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598585",
            "telephone_number": "225-620-7589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4159 STECK AVE",
            "address_2": "UNIT 111",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598585",
            "telephone_number": "225-620-7589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUQUOI-ELLISON",
        "first_name": "HEATHER",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-12",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "TX",
            "license": "11198976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Haley Bunting
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• Shannon L Bupp, LCDC
• Bur Oak Med Dev LLC
• Delfina Bur, MD
• Leah Nichole Burandt, PA
• Graciela Burback
• Shelby Burbank

• Lactation Consultant (Non-RN) in Austin, TX
• Providers in Austin, TX by specialty
• Lactation Consultant (Non-RN) in Texas

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