Provider Demographics
NPI:1063954121
Name:HAMBY, JANUARY (APRN)
Entity type:Individual
Prefix:
First Name:JANUARY
Middle Name:
Last Name:HAMBY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 E BRANNON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-7919
Mailing Address - Country:US
Mailing Address - Phone:502-594-1367
Mailing Address - Fax:859-278-6867
Practice Address - Street 1:740 S LIMESTONE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-7919
Practice Address - Country:US
Practice Address - Phone:859-323-6700
Practice Address - Fax:859-257-1331
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011357363LP2300X, 363L00000X
KY1091604163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1091604OtherRN LICENSE