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General NPI Number Information
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NPI Number | 1255761144
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Entity Type | Individual
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Provider Name | MELINDA OLIVAREZ GUTIERREZ RN, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 11/14/2013
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 662 KATHERINE CT
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City | EL PASO
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State | TX
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Zip | 79932-3158
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Country | US
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Telephone | 915-373-8361
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Fax |
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Provider Business Mailing Address
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Address Line | 1712 GREEN MOUNTAIN TPKE
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City | CHESTER
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State | VT
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Zip | 05143-8321
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Country | US
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Telephone | 888-818-5653
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Fax | 802-875-6455
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | L-14410
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 666901
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License Number State | TX
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