MEDICARE: JASMINE WRENN 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
1	163WL0100X	Lactation Consultant (Registered Nurse)	0001280598	VA

General Provider Information

NPI Number	:	1467378521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE WRENN RN, IBCLC

Provider Business Mailing Address
First Line	:	8401 MAYLAND DR STE V
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4648
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8401 MAYLAND DR STE V
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4648
Country	:	US
Telephone Number	:	757-563-3641
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2026
Last Update Date	:	06/24/2026

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