Melissa Logan, IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

L-109999 Issued in AR

Practice address

8099 Warren Rd
Decatur, AR 72722-9406

Phone

(480) 603-6261

NPI assigned

Sep 9, 2020

Last updated

Sep 9, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1194330951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8099 WARREN RD",
            "city": "DECATUR",
            "state": "AR",
            "postal_code": "727229406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8099 WARREN RD",
            "city": "DECATUR",
            "state": "AR",
            "postal_code": "727229406",
            "telephone_number": "480-603-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "MELISSA",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "AR",
            "license": "L-109999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell Atkins, APRN
• Decatur Public Schools
• Decatur School District
• Kids for the Future of Western Benton County, LLC (KidsCorp West)
• Mikia Kilcrease, PMHNP-BC
• Sgoh Acquisition Inc (Och Decatur Clinic)
• Laticia Kay Sheffield, APRN
• Tara Skinner
• Spavinaw Clinics, Inc (Decatur Medi Clinic)
• Jesse A Stafford, P.A.-C

• Lactation Consultant (Registered Nurse) in Decatur, AR
• Providers in Decatur, AR by specialty
• Lactation Consultant (Registered Nurse) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.