Provider Demographics
NPI:1679457782
Name:ISBELL, LYNETTE SUZANNE (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:LYNETTE
Middle Name:SUZANNE
Last Name:ISBELL
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 SHAW AVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:IL
Mailing Address - Zip Code:61944
Mailing Address - Country:US
Mailing Address - Phone:217-465-2212
Mailing Address - Fax:217-465-1121
Practice Address - Street 1:502 SHAW AVE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:IL
Practice Address - Zip Code:61944
Practice Address - Country:US
Practice Address - Phone:217-465-2212
Practice Address - Fax:217-465-1121
Is Sole Proprietor?:No
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-521778163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3760000746001Medicaid