Healthcare Provider Details

I. General information

NPI: 1417881186
Provider Name (Legal Business Name): ALYCIA CHRISTINE JANOW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S 8TH ST STE 208E
MURRAY KY
42071-2472
US

IV. Provider business mailing address

300 S 8TH ST STE 208E
MURRAY KY
42071-2472
US

V. Phone/Fax

Practice location:
  • Phone: 270-759-9223
  • Fax:
Mailing address:
  • Phone: 270-759-9223
  • Fax: 270-752-2859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberI-302114
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: