Provider Demographics
NPI:1467584631
Name:CONORD-MORROW, MELISSA K (LM, RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:K
Last Name:CONORD-MORROW
Suffix:
Gender:F
Credentials:LM, RN, IBCLC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LM, CPM
Mailing Address - Street 1:3914 SUNSET LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33810-2839
Mailing Address - Country:US
Mailing Address - Phone:863-559-1991
Mailing Address - Fax:888-299-6337
Practice Address - Street 1:1525 EDGEWATER BEACH DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-4737
Practice Address - Country:US
Practice Address - Phone:863-680-2229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL-127181163WL0100X
374J00000X
FLMW175176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No374J00000XNursing Service Related ProvidersDoula