MEDICARE: SIMPLY NURSING, LLC

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	174N00000X	Lactation Consultant (Non-RN)

General Provider Information

NPI Number	:	1508450537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMPLY NURSING, LLC

Provider Business Mailing Address
First Line	:	1151 SCHOOL HOUSE LN STE 100
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-5669
Country	:	US
Telephone Number	:	610-357-5376
Fax Number	:

Provider Business Practice Location Address
First Line	:	1151 SCHOOL HOUSE LN STE 100
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-5669
Country	:	US
Telephone Number	:	610-357-5376
Fax Number	:

Authorized Official
Title or Position	:	OWNER/IBCLC
Name	:	STEPHANIE LEONETTI
Credential	:	IBCLC
Telephone Number	:	610-357-5376

Provider Enumeration Date	:	02/20/2021
Last Update Date	:	02/20/2021

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