Antoinette Cornelius, CLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

361012 Issued in AZ

Practice address

3081 E Wiley LN
Vail, AZ 85641-9716

Phone

(520) 507-0286

NPI assigned

Jul 9, 2025

Last updated

Jul 9, 2025By 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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lactation Consultants of America

  • Lactation Consultant (Non-RN)
  • Big Bear City, CA
  • NPI 1740929694

  Lactation Consultant, Non-RN

  NPD (past)

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1730079856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3081 E WILEY LN",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "856419716",
            "telephone_number": "520-507-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3081 E WILEY LN",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "856419716",
            "telephone_number": "520-507-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "ANTOINETTE",
        "credential": "CLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "AZ",
            "license": "361012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lactation Consultant (Non-RN) in Vail, AZ
• Providers in Vail, AZ by specialty
• Lactation Consultant (Non-RN) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; 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.