Individual
ANNICE ROSE MASSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
7321 TICONDEROGA DR, LOUISVILLE, KY 40214-4158
(775) 856-9225
Mailing address
7321 TICONDEROGA DR, LOUISVILLE, KY 40214-4158
(775) 856-9225
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-306846
KY
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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