Individual
MELINDA HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN, IBCLC
Contact information
Practice address
320 HIGH TIDE DR, SUITE 101, ST AUGUSTINE, FL 32080-2323
(904) 823-6013
Mailing address
240 BIG MAGNOLIA CT, ST AUGUSTINE, FL 32080-1700
(904) 823-6013
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
RN1792962
FL
Other
Enumeration date
12/03/2012
Last updated
12/03/2012
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