Provider Demographics
NPI:1124881859
Name:CARNAGHI, HEATHER ANN (RN-IBCLC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANN
Last Name:CARNAGHI
Suffix:
Gender:F
Credentials:RN-IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 PANORAMA DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-1560
Mailing Address - Country:US
Mailing Address - Phone:248-830-6601
Mailing Address - Fax:
Practice Address - Street 1:910 PANORAMA DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-1560
Practice Address - Country:US
Practice Address - Phone:248-830-6601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704244072163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant