Provider Demographics
NPI:1306430319
Name:HUESMANN, KRISTIANNA L (IBCLC)
Entity type:Individual
Prefix:
First Name:KRISTIANNA
Middle Name:L
Last Name:HUESMANN
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 1:560 HAMMOND CROSS RD
Mailing Address - Street 2:
Mailing Address - City:ST MATTHEWS
Mailing Address - State:SC
Mailing Address - Zip Code:29135-7726
Mailing Address - Country:US
Mailing Address - Phone:843-701-0260
Mailing Address - Fax:
Practice Address - Street 1:560 HAMMOND CROSS RD
Practice Address - Street 2:
Practice Address - City:ST MATTHEWS
Practice Address - State:SC
Practice Address - Zip Code:29135-7726
Practice Address - Country:US
Practice Address - Phone:843-701-0260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2025-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-309694174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN