Doctor Name: | MELISSA ARLANE LANDRETH |
NPI Number: | 1053659581 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RNC, IBCLC |
License Number: | 116460 |
Business Practice Address: | 211 Saint Francis Dr Cape Girardeau, MO - 637035049 |
Business Phone Number: | 5733315565 |
Business Fax Number: | |
Mailing Address: | 4916 Pinedale, JACKSON |
State: | MO |
Postal Code: | 637552521 |
Phone Number: | 5733397111 |
Fax Number: | |
NPI Enumeration Date: | 01/17/2013 |
NPI Last Update Date: | 01/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WL0100X |
License Number: | 116460 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Lactation Consultant |
Taxonomy Definition: |