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NPI Code Detail

MEDICARE: CHRISTY DIANNE BEITEL RN, IBCLC

MEDICARE:   CHRISTY DIANNE BEITEL  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)RN9363955FL

General Provider Information

NPI Number : 1184495509
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTY DIANNE BEITEL RN, IBCLC
Provider Business Mailing Address
First Line : 343 WHISPERING LAKE DR
Second Line :
City : SANTA ROSA BEACH
State : FL
Zip : 32459-4292
Country : US
Telephone Number : 256-426-9552
Fax Number :
Provider Business Practice Location Address
First Line : 314 E STATE ST
Second Line :
City : ITHACA
State : NY
Zip : 14850-4318
Country : US
Telephone Number : 888-458-1364
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2024
Last Update Date : 01/15/2024

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