Provider Demographics
NPI:1730742990
Name:HAMPTON, JANIS FAY (IBCLC)
Entity type:Individual
Prefix:
First Name:JANIS
Middle Name:FAY
Last Name:HAMPTON
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 1:309 BASTIAN LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-2076
Mailing Address - Country:US
Mailing Address - Phone:512-630-3672
Mailing Address - Fax:
Practice Address - Street 1:309 BASTIAN LN
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-2076
Practice Address - Country:US
Practice Address - Phone:512-630-3672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-13768174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN