Provider Demographics
NPI:1861834376
Name:COURSEY, CHRISTIE WARD (IBCLC)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:WARD
Last Name:COURSEY
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 1:50 PLAZA WAY NW STE E
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1141
Mailing Address - Country:US
Mailing Address - Phone:404-454-9715
Mailing Address - Fax:
Practice Address - Street 1:1 BALTIMORE PL NW STE 160
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2118
Practice Address - Country:US
Practice Address - Phone:404-454-9715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALC000112174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN