Advanced Breastfeeding Support of Las Vegas

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

Legal business name

ADVANCED BREASTFEEDING SUPPORT OF LAS VEGAS

Doing business as

Autumn Wake, RN, BSN, Ibclc

Practice address

6970 S Cimarron Rd Ste 100
Las Vegas, NV 89113-2135

Phone

(702) 764-9290

Fax

(702) 473-5383

NPI assigned

Mar 19, 2019

Last updated

Mar 20, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Autumn Wake, RN, BSN, IBCLC

Title

Owner/Practitioner

Phone

(702) 764-9290

Specialties & licenses 1

Addresses

Other names 1

• AUTUMN WAKE, RN, BSN, IBCLC Doing business as

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553040000000",
    "number": "1902365869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6970 S CIMARRON RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132135",
            "telephone_number": "702-764-9290",
            "fax_number": "702-473-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6970 S CIMARRON RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132135",
            "telephone_number": "702-764-9290",
            "fax_number": "702-473-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED BREASTFEEDING SUPPORT OF LAS VEGAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-19",
        "last_updated": "2019-03-20",
        "status": "A",
        "authorized_official_last_name": "WAKE",
        "authorized_official_first_name": "AUTUMN",
        "authorized_official_title_or_position": "OWNER/PRACTITIONER",
        "authorized_official_telephone_number": "702-764-9290",
        "authorized_official_credential": "RN, BSN, IBCLC"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AUTUMN WAKE, RN, BSN, IBCLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AUTUMN WAKE, RN, BSN, IBCLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lactation Consultant (Registered Nurse) in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Lactation Consultant (Registered Nurse) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; 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.