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NPI Code Detail

MEDICARE: MELINDA OLIVAREZ GUTIERREZ RN, IBCLC

MEDICARE: MELINDA OLIVAREZ GUTIERREZ RN, IBCLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WL0100XLactation Consultant (Registered Nurse)L-14410TX
2163W00000XRegistered Nurse666901TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255761144
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELINDA OLIVAREZ GUTIERREZ RN, IBCLC
Provider Business Mailing Address
First Line : 1712 GREEN MOUNTAIN TPKE
Second Line :
City : CHESTER
State : VT
Zip : 05143-8321
Country : US
Telephone Number : 888-818-5653
Fax Number : 802-875-6455
Provider Business Practice Location Address
First Line : 662 KATHERINE CT
Second Line :
City : EL PASO
State : TX
Zip : 79932-3158
Country : US
Telephone Number : 915-373-8361
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2013
Last Update Date : 02/10/2025

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