Provider Demographics
NPI:1295943744
Name:HENNES, CHRISTINE (IBCLC)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:HENNES
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 1:6924 HYDE PARK DR UNIT 318
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-2263
Mailing Address - Country:US
Mailing Address - Phone:619-990-6479
Mailing Address - Fax:
Practice Address - Street 1:6924 HYDE PARK DR UNIT 318
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-2263
Practice Address - Country:US
Practice Address - Phone:619-990-6479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist