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NPI Code Detail

MEDICARE: MISHELLE K TRESCOTT RN, IBCLC

MEDICARE: MISHELLE K TRESCOTT 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
1164W00000XLicensed Practical NurseLPN.124620.MEDS-IVOH
2163WL0100XLactation Consultant (Registered Nurse)RN.509411OH

General Provider Information

NPI Number : 1548814494
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISHELLE K TRESCOTT RN, IBCLC
Provider Business Mailing Address
First Line : 841 STEUBENVILLE AVE
Second Line :
City : CAMBRIDGE
State : OH
Zip : 43725-2301
Country : US
Telephone Number : 855-692-7247
Fax Number : 855-692-7247
Provider Business Practice Location Address
First Line : 314 E STATE ST
Second Line :
City : ITHACA
State : NY
Zip : 14850-4318
Country : US
Telephone Number : 740-509-2498
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2019
Last Update Date : 08/25/2022

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