Provider Demographics
NPI:1558017467
Name:HARRIGAN, MRIKA KADELI (IBCLC, CHES, CLC)
Entity Type:Individual
Prefix:
First Name:MRIKA
Middle Name:KADELI
Last Name:HARRIGAN
Suffix:
Gender:F
Credentials:IBCLC, CHES, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 CROSSTERN CT
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-4002
Mailing Address - Country:US
Mailing Address - Phone:703-505-4376
Mailing Address - Fax:
Practice Address - Street 1:216 CROSSTERN CT
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-4002
Practice Address - Country:US
Practice Address - Phone:703-505-4376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24589174H00000X
NC341032174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No174H00000XOther Service ProvidersHealth Educator