Healthcare Provider Details

I. General information

NPI: 1437981198
Provider Name (Legal Business Name): JULIA ALLEN RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 MONARCH ST STE 130
LEXINGTON KY
40513-1904
US

IV. Provider business mailing address

110 SPRING RIDGE WAY
WINCHESTER KY
40391-9682
US

V. Phone/Fax

Practice location:
  • Phone: 859-595-8010
  • Fax:
Mailing address:
  • Phone: 859-595-8010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-314202
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: