Healthcare Provider Details

I. General information

NPI: 1538093646
Provider Name (Legal Business Name): ALLISON THELLMAN BSN,RN,IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

381 WILSON RD
CLINTON PA
15026-1596
US

IV. Provider business mailing address

381 WILSON RD
CLINTON PA
15026-1596
US

V. Phone/Fax

Practice location:
  • Phone: 888-991-6772
  • Fax:
Mailing address:
  • Phone: 888-991-6772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-315250
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: