Provider Demographics
NPI:1164136933
Name:LUGINBUHL, JESSICA CULLEN (IBCLC, MPH)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:CULLEN
Last Name:LUGINBUHL
Suffix:
Gender:F
Credentials:IBCLC, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 W KNOX ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-1524
Mailing Address - Country:US
Mailing Address - Phone:773-551-7086
Mailing Address - Fax:
Practice Address - Street 1:111 KNOX WAY STE 110
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-6615
Practice Address - Country:US
Practice Address - Phone:919-438-2293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-308321174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
L-308321OtherINTERNATIONAL BOARD CERTIFIED LACTATION EXAMINERS