Healthcare Provider Details

I. General information

NPI: 1164372744
Provider Name (Legal Business Name): CHRISTINA L HUEY RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 02/02/2026
Certification Date: 02/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7549 BUFFALO RIDGE RD
PACE FL
32571-9860
US

IV. Provider business mailing address

7549 BUFFALO RIDGE RD
PACE FL
32571-9860
US

V. Phone/Fax

Practice location:
  • Phone: 850-292-8106
  • Fax:
Mailing address:
  • Phone: 850-292-8106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number9252842
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: