Heather Marie Carreon, RN, IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

L-109519 Issued in VA

Practice address

188 Marywood Dr
Clayton, NC 27520-9066

Phone

(304) 890-8021

NPI assigned

May 17, 2021

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1962076653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 MARYWOOD DR",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275209066",
            "telephone_number": "304-890-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 MARYWOOD DR",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275209066",
            "telephone_number": "304-890-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARREON",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "VA",
            "license": "L-109519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lactation Consultant (Registered Nurse) in Clayton, NC
• Providers in Clayton, NC by specialty
• Lactation Consultant (Registered Nurse) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.