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NPI Code Detail

MEDICARE: JEANNE BYLER MITCHELL MSN RN IBCLC

MEDICARE: JEANNE BYLER MITCHELL MSN 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)611258TX

General Provider Information

NPI Number : 1770126914
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNE BYLER MITCHELL MSN RN IBCLC
Provider Business Mailing Address
First Line : 111 RAMBLE LN STE 115
Second Line :
City : AUSTIN
State : TX
Zip : 78745-2281
Country : US
Telephone Number : 512-808-0237
Fax Number :
Provider Business Practice Location Address
First Line : 111 RAMBLE LN STE 115
Second Line :
City : AUSTIN
State : TX
Zip : 78745-2281
Country : US
Telephone Number : 512-808-0237
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2019
Last Update Date : 10/21/2019

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