Provider Demographics
NPI:1689307951
Name:HIGUERA ANCIDEY, LINELS AYMEE (IBCLC)
Entity Type:Individual
Prefix:
First Name:LINELS
Middle Name:AYMEE
Last Name:HIGUERA ANCIDEY
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 1:3813 BUCKSKIN WAY
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-9816
Mailing Address - Country:US
Mailing Address - Phone:336-543-5985
Mailing Address - Fax:
Practice Address - Street 1:3813 BUCKSKIN WAY
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-9816
Practice Address - Country:US
Practice Address - Phone:336-543-5985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-301191174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN