Provider Demographics
NPI:1548814494
Name:TRESCOTT, MISHELLE K (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:MISHELLE
Middle Name:K
Last Name:TRESCOTT
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:MISHELLE
Other - Middle Name:K
Other - Last Name:KEMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:841 STEUBENVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-2301
Mailing Address - Country:US
Mailing Address - Phone:855-692-7247
Mailing Address - Fax:855-692-7247
Practice Address - Street 1:314 E STATE ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4318
Practice Address - Country:US
Practice Address - Phone:740-509-2498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.124620.MEDS-IV164W00000X
OHRN.509411163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No164W00000XNursing Service ProvidersLicensed Practical Nurse