Provider Demographics
NPI:1215275540
Name:CARRAWAY, JANET DONNELLY (RNC, BSN, IBCLC)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:DONNELLY
Last Name:CARRAWAY
Suffix:
Gender:F
Credentials:RNC, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13805 COWART RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004-3508
Mailing Address - Country:US
Mailing Address - Phone:770-380-0907
Mailing Address - Fax:
Practice Address - Street 1:13805 COWART RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:GA
Practice Address - Zip Code:30004-3508
Practice Address - Country:US
Practice Address - Phone:770-380-0907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-21
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN076589163WL0100X
GA11095444174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No174N00000XOther Service ProvidersLactation Consultant, Non-RN