Breon Maree Henderson, RNC, MSN, CLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

95023758 Issued in CA

Practice address

510 Cypress St
Ste D
Fort Bragg, CA 95437-5411

Phone

(707) 964-5696

Fax

(707) 964-6274

NPI assigned

Jan 6, 2017

Last updated

Jan 6, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Credentials

Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1851837454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 CYPRESS ST",
            "address_2": "STE D",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375411",
            "telephone_number": "707-964-5696",
            "fax_number": "707-964-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 CYPRESS ST",
            "address_2": "STE D",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375411",
            "telephone_number": "707-964-5696",
            "fax_number": "707-964-6274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "BREON",
        "middle_name": "MAREE",
        "credential": "RNC, MSN, CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-06",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CA",
            "license": "95023758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Jasmine Head, LAC, MAOM
• Arwen Hebden
• Elaine Heine
• Larry Ira Heiss, MD
• Waltraud Helma
• Suzanne H. Hewitt, FNP
• Anne Hill, ACSW
• Larry D Hinson, R.P.T.
• Tiffany Hobbs
• Simon Hodson, MFT

• Lactation Consultant (Registered Nurse) in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Lactation Consultant (Registered Nurse) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; 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.