Provider Demographics
NPI:1487315453
Name:SMIGIEL, ALLISON ELIZABETH (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:ELIZABETH
Last Name:SMIGIEL
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-1902
Mailing Address - Country:US
Mailing Address - Phone:607-592-6357
Mailing Address - Fax:
Practice Address - Street 1:VIRTUAL HOME OFFICE
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850
Practice Address - Country:US
Practice Address - Phone:607-258-5616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY616349-01163WL0100X, 163WP1700X
171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP1700XNursing Service ProvidersRegistered NursePerinatal
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No171400000XOther Service ProvidersHealth & Wellness Coach