Healthcare Provider Details

I. General information

NPI: 1962870709
Provider Name (Legal Business Name): MELANIE GARLAND RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2015
Last Update Date: 09/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 LAKELAND DR ATHENS
ATHENS GA
30607-2094
US

IV. Provider business mailing address

345 LAKELAND DR ATHENS
ATHENS GA
30607-2094
US

V. Phone/Fax

Practice location:
  • Phone: 706-354-0265
  • Fax:
Mailing address:
  • Phone: 706-354-0265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN135045
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: