Provider Demographics
NPI:1639425077
Name:CHRISTIAN, ANN-MARIE J (IBCLC)
Entity Type:Individual
Prefix:
First Name:ANN-MARIE
Middle Name:J
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 S MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95242-3835
Mailing Address - Country:US
Mailing Address - Phone:310-946-5758
Mailing Address - Fax:209-334-2326
Practice Address - Street 1:1121 S MILLS AVE
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-3835
Practice Address - Country:US
Practice Address - Phone:310-946-5758
Practice Address - Fax:209-334-2326
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN