Melissa Anne Kochuba, R.N, I.B.C.L.C
Registered Nurse, Lactation Consultant in Fairfax, VA. Individual provider (NPI-1).
NPI number1194132985
StatusActive
Last updated in NPPESDec 17, 2024
Details
- NPI
- 1194132985
- Entity type
- Individual (NPI-1)
- Name
- Ms. Melissa Anne Kochuba
- Credential
- R.N, I.B.C.L.C
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 14, 2014
- Certification date
- Dec 17, 2024
- Last updated
- Dec 17, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WL0100X | Registered Nurse, Lactation Consultant | 617102-1 | NY | Yes |
| 163WL0100X | Registered Nurse, Lactation Consultant | 6171021 | NY |
Practice location
12608 Lake Normandy LnFairfax, VA 22030-7251
Phone 516-993-3094
Mailing address
12608 Lake Normandy LnFairfax, VA 22030-7251
Phone 516-993-3094
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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