Devastasha Beaver, IBCLC

Key facts

NPI

1831789478

Entity type

Individual (NPI type 1)

Primary specialty

Lactation Consultant (Non-RN) 174N00000X

Practice address

15 E Erie St
Jefferson, OH 44047-1410

Phone

(440) 812-7630

NPI assigned

Jan 18, 2021

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 18, 2021.

{
    "created_epoch": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1831789478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 E ERIE ST",
            "city": "JEFFERSON",
            "state": "OH",
            "postal_code": "440471410",
            "telephone_number": "440-812-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 E ERIE ST",
            "city": "JEFFERSON",
            "state": "OH",
            "postal_code": "440471410",
            "telephone_number": "440-812-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVER",
        "first_name": "DEVASTASHA",
        "credential": "IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-18",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Jefferson, OH · Lactation Consultant (Non-RN) in Ohio