Kristin Nichole Eagan, CLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

337700 Issued in OH

Practice address

2011 Archmore Dr
Kettering, OH 45440-1801

Phone

(937) 239-7229

NPI assigned

Apr 5, 2022

Last updated

Apr 5, 2022By 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

Electronic endpoints 1

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1871234864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 ARCHMORE DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454401801",
            "telephone_number": "937-239-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 ARCHMORE DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454401801",
            "telephone_number": "937-239-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGAN",
        "first_name": "KRISTIN",
        "middle_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "credential": "CLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "OH",
            "license": "337700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kreaganlactation.com",
            "affiliation": "N",
            "address_1": "2011 Archmore Dr",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454401801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mary Jo Dupree
• David Durkey
• Vicki S Dursch, CRNA
• Beth Eileen Shepard Dutro, CRNA
• Rebekah Anne Duvall
• Marie R Eakle, RN
• Meaghan Frances Ebetino, M.D., M.P.H.
• Michelle Eby, PHARM.D.
• Carissa Lynn Eckert, PT
• Julie Ann Edsall, LPCC

• Lactation Consultant (Non-RN) in Kettering, OH
• Providers in Kettering, OH by specialty
• Lactation Consultant (Non-RN) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.