Provider Demographics
NPI:1902131907
Name:BINKLEY, KARISSA L (LCCE, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:KARISSA
Middle Name:L
Last Name:BINKLEY
Suffix:
Gender:F
Credentials:LCCE, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 KELLYRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-9611
Mailing Address - Country:US
Mailing Address - Phone:919-961-9885
Mailing Address - Fax:
Practice Address - Street 1:307 KELLYRIDGE DR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-9611
Practice Address - Country:US
Practice Address - Phone:919-961-9885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-08
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC264567386OtherEIN