Provider Demographics
NPI:1851154678
Name:GIORDANO, KELLY LYNN (MSN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:LYNN
Last Name:GIORDANO
Suffix:
Gender:F
Credentials:MSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 S US HIGHWAY 1 STE F5
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-5166
Mailing Address - Country:US
Mailing Address - Phone:561-312-9418
Mailing Address - Fax:
Practice Address - Street 1:1100 VIA ROYALE APT 1111
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7075
Practice Address - Country:US
Practice Address - Phone:561-312-9418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAL-302920163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant