Provider Demographics
NPI:1366051856
Name:HUNT, MELISSA (IBCLC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:HUNT
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4829 E STREET RD
Mailing Address - Street 2:
Mailing Address - City:TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6647
Mailing Address - Country:US
Mailing Address - Phone:215-364-5800
Mailing Address - Fax:215-364-5899
Practice Address - Street 1:4829 E STREET RD
Practice Address - Street 2:
Practice Address - City:TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6647
Practice Address - Country:US
Practice Address - Phone:215-364-5800
Practice Address - Fax:215-364-5899
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN620129163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant