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1669880712 NPI number — CHRISTINA BLAKE FNP, IBCLC

NPI Number: 1669880712
Health Care Provider/Practitioner: CHRISTINA BLAKE FNP, IBCLC

Information about “1669880712” NPI (CHRISTINA BLAKE FNP, IBCLC) exists in 1669880712 in HTML format HTML  |  1669880712 in plain Text format TXT  |  1669880712 in PDF (Portable Document Format) PDF  |  1669880712 in an XML format XML  formats.

NPI Number : 1669880712 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1669880712",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BLAKE",
    "FirstName": "CHRISTINA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "FNP, IBCLC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BARBER",
    "OtherFirstName": "CHRISTINA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "839 W CONGRESS ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TUCSON",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85745-2819",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "520-670-3090",
    "MailingAddressFaxNumber": "520-309-2560",
    "FirstLinePracticeLocationAddress": "EL RIO HEALTH",
    "SecondLinePracticeLocationAddress": "839 W CONGRESS ST",
    "PracticeLocationAddressCityName": "TUCSON",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85745",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "520-670-3909",
    "PracticeLocationAddressFaxNumber": "520-309-2560",
    "EnumerationDate": "07/31/2014",
    "LastUpdateDate": "05/09/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "163WL0100X",
          "TaxonomyName": "Lactation Consultant (Registered Nurse)",
          "LicenseNumber": "L-41735",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "319183",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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