Provider Demographics
NPI:1326847989
Name:NECAISE, ANNE A (RDN, IBCLC)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:A
Last Name:NECAISE
Suffix:
Gender:
Credentials:RDN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3249 COPPER RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:CANTONMENT
Mailing Address - State:FL
Mailing Address - Zip Code:32533-6509
Mailing Address - Country:US
Mailing Address - Phone:423-367-1191
Mailing Address - Fax:
Practice Address - Street 1:3249 COPPER RIDGE CIR
Practice Address - Street 2:
Practice Address - City:CANTONMENT
Practice Address - State:FL
Practice Address - Zip Code:32533-6509
Practice Address - Country:US
Practice Address - Phone:423-367-1191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174N00000X
FL7037133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered