Angela Mann, RNC-OB, IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

L85488 Issued in MO

Practice address

505 Turtle Creek CT
O Fallon, IL 62269-3053

Phone

(618) 520-9898

NPI assigned

Apr 6, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1437738465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 TURTLE CREEK CT",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693053",
            "telephone_number": "618-520-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 TURTLE CREEK CT",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693053",
            "telephone_number": "618-520-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "ANGELA",
        "credential": "RNC-OB, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MO",
            "license": "L85488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Maggio
• Main Street Medical Group LLC
• Carol A Makarewicz, RPH
• Gabriele E Malone, RBT
• Angela Nicole Mangum
• Sarah R Mannix
• Jami Lee Mannle, FNP-BC
• Crystal Vaughn Manse, M.D.
• Johnathan Jay Marchbanks, MSW
• Alexandria Marion, RBT

• Lactation Consultant (Registered Nurse) in O Fallon, IL
• Providers in O Fallon, IL by specialty
• Lactation Consultant (Registered Nurse) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.