Provider Demographics
NPI:1114819851
Name:COWAN, MIKA (IBCLC)
Entity type:Individual
Prefix:
First Name:MIKA
Middle Name:
Last Name:COWAN
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 1:1029 MONARCH ST STE 130
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1904
Mailing Address - Country:US
Mailing Address - Phone:859-456-2025
Mailing Address - Fax:
Practice Address - Street 1:1029 MONARCH ST STE 130
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1904
Practice Address - Country:US
Practice Address - Phone:859-456-2025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYL-319127174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN