Provider Demographics
NPI:1073249819
Name:LYNN, HEATHER HIGGINS (PHD, EDM, BA, IBCLC)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:HIGGINS
Last Name:LYNN
Suffix:
Gender:F
Credentials:PHD, EDM, BA, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2091 PLEASANT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-9250
Mailing Address - Country:US
Mailing Address - Phone:336-337-7533
Mailing Address - Fax:
Practice Address - Street 1:2091 PLEASANT RIDGE RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-9250
Practice Address - Country:US
Practice Address - Phone:336-337-7533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL-136406174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN