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Individual

SYDNEY ELIZABETH LOGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LM, CPM

Contact information

Practice address
2301 PARK AVE STE 203, ORANGE PARK, FL 32073-5558
(904) 203-8559
Mailing address
1332 CAMPBELL AVE, JACKSONVILLE, FL 32207-2212
(740) 398-4952

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
405
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
405
FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
04/05/2021
Last updated
04/05/2021
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