Individual
MISS MELISSA THORBJORNSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN, IBCLC
Contact information
Practice address
975 S FAIRMONT AVE, LODI, CA 95240-5118
(209) 339-7522
Mailing address
1511 S MILLS AVE APT 137, LODI, CA 95242-4244
(605) 390-9178
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
710547
CA
163WP1700X
Perinatal Registered Nurse
710547
CA
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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