Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | ||
Y | 176B00000X | Midwife | 22012 | SC |
NPI | 1104312214 |
---|---|
Provider Name | Melanie Kittrell |
First Address | St Matthews, SC 29135-8030 |
Second Address | Orangeburg, SC 29115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2018 |
Last Update Date | 18/07/2018 |