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Individual

MELISSA JEAN CARDWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
20272
SC
363LW0102X
Women's Health Nurse Practitioner
Primary
20272
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20272
LICENSE
SC
Enumeration date
08/10/2016
Last updated
03/17/2018
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