Provider Demographics
NPI:1144950510
Name:WRENN, MELISSA SHEFFIELD (LAC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:SHEFFIELD
Last Name:WRENN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 SAINT JOHNS AVE
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-3902
Mailing Address - Country:US
Mailing Address - Phone:382-325-8305
Mailing Address - Fax:
Practice Address - Street 1:3800 SAINT JOHNS AVE
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-3902
Practice Address - Country:US
Practice Address - Phone:382-325-8305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4364171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist