Provider Demographics
NPI:1265146492
Name:HNOSKO, MELISSA KATHLEEN (IBCLC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:KATHLEEN
Last Name:HNOSKO
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6730 S 43RD ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-5136
Mailing Address - Country:US
Mailing Address - Phone:402-937-1220
Mailing Address - Fax:531-248-4981
Practice Address - Street 1:6730 S 43RD ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5136
Practice Address - Country:US
Practice Address - Phone:402-937-1220
Practice Address - Fax:531-248-4981
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEL-309449174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
L-309449OtherINTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS