Individual
SHANNON GAYDESKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
310 NEW BRIDGE ST, JACKSONVILLE, NC 28540-4756
(910) 621-4266
(910) 613-0382
Mailing address
310 NEW BRIDGE ST, JACKSONVILLE, NC 28540-4756
(910) 621-4266
(910) 613-0382
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-107778
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000
N/A
—
Enumeration date
03/01/2021
Last updated
03/01/2021
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