Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Krystle Wallace, IBCLC

Individual provider Lactation Consultant (Non-RN) · NPI 1699495325

Krystle Wallace, IBCLC is a Lactation Consultant (Non-RN) in Bowie, Maryland. Practices as a sole proprietor. Registered with an NPI since 2022.

In the registry since
2022
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Practice location Address checks out

16002 Philmont Ln
Bowie, MD 20716-1619
Phone: (203) 231-0947
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Specialties & licences

Lactation Consultant (Non-RN) (primary) Taxonomy 174N00000X

Record details

NPI number1699495325
Entity typeIndividual (Type 1)
GenderFemale
Credentials IBCLC
Sole proprietorYes
NPI enumeratedSeptember 1, 2022
Last updated in NPPESSeptember 1, 2022
Certification dateSeptember 1, 2022
Mailing address16002 Philmont Ln, Bowie, MD 20716-1619

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