Provider Demographics
NPI:1972115459
Name:ROSSIGNOL, COURTNEY LYNN (IBCLC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LYNN
Last Name:ROSSIGNOL
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 1:73 BRENDA LN
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:CT
Mailing Address - Zip Code:06238-1648
Mailing Address - Country:US
Mailing Address - Phone:860-833-9620
Mailing Address - Fax:
Practice Address - Street 1:73 BRENDA LN
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:CT
Practice Address - Zip Code:06238-1648
Practice Address - Country:US
Practice Address - Phone:860-833-9620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN